Micklefield G
MMW Fortschr Med. 2014 Apr 17;156 Suppl 1:18-22.
Antibiotic-associated diarrhea (AAD) is the most frequent side effect of antibiotic therapy. Clinical signs and symptoms comprise mild and self-limiting courses of diarrhea as well as life threatening courses like pseudomembranous colitis or toxic megacolon. Therapy is symptomatic, antidiarrheal drugs like Saccharomyces boulardii are the therapy of choice.
Available studies on S. boulardii in the prevention of AAD are presented as a review.
In 14 out of 17 studies including 4,627 patients the administration of S. boulardii achieved a protective effect between 43.7% and 87.3%. A meta-analysis (5 studies, 1,076 patients) showed a significant reduction of the risk to develop an AAD from 17.2% to 6.7%,in a furthermeta-analysis (4 studies on eradication of H. pylori, 1,215 patients) the significant reductionwasfrom 12.2% to 5.6%.
There is very good evidence for the yeast S. boulardii to be effective in the prevention of AAD especially in hospitalized adults. The simultaneous administration of S. boulardii to antibiotics resulted in a significant reduction to develop AAD by more than half.
抗生素相关性腹泻(AAD)是抗生素治疗最常见的副作用。临床症状包括轻度且自限性的腹泻病程以及危及生命的病程,如假膜性结肠炎或中毒性巨结肠。治疗以对症治疗为主,像布拉氏酵母菌这样的止泻药物是首选治疗方法。
对现有的关于布拉氏酵母菌预防AAD的研究进行综述。
在17项研究中的14项(共4627例患者)中,给予布拉氏酵母菌可产生43.7%至87.3%的保护效果。一项荟萃分析(5项研究,1076例患者)显示,发生AAD的风险从17.2%显著降低至6.7%,在另一项荟萃分析(4项关于根除幽门螺杆菌的研究,1215例患者)中,显著降低幅度从12.2%至5.6%。
有充分证据表明,布拉氏酵母菌对预防AAD有效,尤其是在住院成人中。同时给予布拉氏酵母菌和抗生素可使发生AAD的风险显著降低一半以上。