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硝唑尼特与益生菌治疗儿童急性轮状病毒腹泻的比较:一项在玻利维亚儿童中进行的随机、单盲、对照试验

Nitazoxanide vs. probiotics for the treatment of acute rotavirus diarrhea in children: a randomized, single-blind, controlled trial in Bolivian children.

作者信息

Teran Carlos G, Teran-Escalera Carlos N, Villarroel Patricia

机构信息

Pediatric Center Albina Patiño, Department of Infectious Disease, Calle Jordan 822, Cochabamba, Bolivia.

出版信息

Int J Infect Dis. 2009 Jul;13(4):518-23. doi: 10.1016/j.ijid.2008.09.014. Epub 2008 Dec 12.

Abstract

BACKGROUND

In previous studies, nitazoxanide has demonstrated a cytoprotective effect against rotavirus, reducing the duration of diarrhea in comparison to placebo. We designed a randomized, single-blind, controlled trial in order to assess the effectiveness of nitazoxanide and probiotics in comparison with a control group.

METHODS

Seventy-five children aged from 28 days to 24 months, with rotavirus diarrhea, were randomly assigned to receive either oral nitazoxanide (15 mg/kg/day) twice a day for three days, a combination of oral probiotics, 1 g twice a day for five days, or only oral or systemic rehydration solutions. The duration of diarrhea and of hospitalization were the primary outcome measures, and daily stool frequency, vomiting, and fever were some of the secondary outcome measures analyzed.

RESULTS

The median duration of hospitalization was significantly shorter (p = 0.017) in patients who received nitazoxanide (81 h) and probiotics (72 h) compared to patients who received oral rehydration solution alone (108 h). Similarly, the median duration of diarrhea was significantly reduced (p = 0.009) in children who received nitazoxanide (54 h) and probiotics (48 h) compared to the control group (79 h).

CONCLUSIONS

Treatment with nitazoxanide and probiotics is effective in the management of children with acute rotavirus diarrhea. Small differences in favor of nitazoxanide were found in comparison with probiotics. Nitazoxanide is an important treatment option for rotavirus diarrhea.

摘要

背景

在先前的研究中,硝唑尼特已显示出对轮状病毒的细胞保护作用,与安慰剂相比,可缩短腹泻持续时间。我们设计了一项随机、单盲、对照试验,以评估硝唑尼特和益生菌与对照组相比的有效性。

方法

75名年龄在28天至24个月之间、患有轮状病毒腹泻的儿童被随机分配,分别接受为期三天、每日两次、每次15mg/kg的口服硝唑尼特治疗,或为期五天、每日两次、每次1g的口服益生菌组合治疗,或仅接受口服或全身补液治疗。腹泻持续时间和住院时间是主要结局指标,每日排便次数、呕吐和发热是分析的部分次要结局指标。

结果

与仅接受口服补液治疗的患者(108小时)相比,接受硝唑尼特(81小时)和益生菌(72小时)治疗的患者住院时间中位数显著缩短(p = 0.017)。同样,与对照组(79小时)相比,接受硝唑尼特(54小时)和益生菌(48小时)治疗的儿童腹泻持续时间中位数显著缩短(p = 0.009)。

结论

硝唑尼特和益生菌治疗对急性轮状病毒腹泻儿童有效。与益生菌相比,硝唑尼特存在细微优势。硝唑尼特是轮状病毒腹泻的重要治疗选择。

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