Szajewska Hania, Ruszczyński Marek, Radzikowski Andrzej
Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, 01-184 Warsaw, Dzialdowska 1, Poland.
J Pediatr. 2006 Sep;149(3):367-372. doi: 10.1016/j.jpeds.2006.04.053.
To systematically evaluate the effectiveness of probiotics in preventing antibiotic-associated diarrhea (AAD) in children.
The following electronic databases up to December 2005, in any language, were searched for studies relevant to AAD and probiotics: MEDLINE, EMBASE, and The Cochrane Library. Only randomized controlled trials (RCT) were considered for study inclusion.
Six placebo-controlled, RCTs (766 children) were included. Treatment with probiotics compared with placebo reduced the risk of AAD from 28.5% to 11.9% (relative risk, RR, 0.44, 95% CI 0.25 to 0.77, random effect model). Preplanned subgroup analysis showed that reduction of the risk of AAD was associated with the use of Lactobacillus GG (2 RCTs, 307 participants, RR 0.3, 95% CI 0.15 to 0.6), S. boulardii (1 RCT, 246 participants, RR 0.2, 95% CI 0.07-0.6), or B. lactis & Str. thermophilus (1 RCT, 157 participants, RR 0.5, 95% CI 0.3 to 0.95).
Probiotics reduce the risk of AAD in children. For every 7 patients that would develop diarrhea while being treated with antibiotics, one fewer will develop AAD if also receiving probiotics.
系统评价益生菌预防儿童抗生素相关性腹泻（AAD）的有效性。
检索截至2005年12月的以下电子数据库，不限语言，查找与AAD和益生菌相关的研究：医学索引数据库（MEDLINE）、荷兰医学文摘数据库（EMBASE）和考克兰图书馆。仅纳入随机对照试验（RCT）进行研究。
纳入6项安慰剂对照的随机对照试验（766名儿童）。益生菌治疗组与安慰剂组相比，AAD风险从28.5%降至11.9%（相对危险度，RR，0.44，95%可信区间0.25至0.77，随机效应模型）。预先计划的亚组分析显示，AAD风险降低与使用鼠李糖乳杆菌GG（2项随机对照试验，307名参与者，RR 0.3，95%可信区间0.15至0.6）、布拉酵母菌（1项随机对照试验，246名参与者，RR 0.2，95%可信区间0.07 - 0.6）或乳酸双歧杆菌和嗜热链球菌（1项随机对照试验，157名参与者，RR 0.5，95%可信区间0.3至0.95）有关。
益生菌可降低儿童AAD风险。在接受抗生素治疗时每7名可能发生腹泻的患者中，如果同时接受益生菌治疗，发生AAD的患者将减少1例。
