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益生菌预防儿童尿路感染的疗效:系统评价和荟萃分析。

The efficacy of probiotics in prevention of urinary tract infection in children: A systematic review and meta-analysis.

机构信息

Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Physiology Research Center and Department of Physiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

J Pediatr Urol. 2017 Dec;13(6):581-591. doi: 10.1016/j.jpurol.2017.08.018. Epub 2017 Oct 9.

Abstract

BACKGROUND

A consensus has not been reached yet about the efficacy of probiotics in reducing the incidence of urinary tract infections (UTIs) in children. This systematic review and meta-analysis was designed to assess the efficacy of probiotics in prevention UTI in children.

METHODS

The present study was designed based on guidelines for systematic reviews of clinical trials. Two independent reviewers performed an extensive search in the Medline, Embase, Web of Science and Scopus electronic databases up to the end of 2016. The summery of eligible studies was assessed independently by two reviewers and recorded in the data extraction form. Finally, a pooled relative risk (RR) was reported with a 95% confidence interval (95% CI).

RESULTS

Data from 10 studies were entered in the present meta-analysis. Probiotic therapy did not have any beneficial effect on the incidence of UTI (RR = 0.94; 95% CI 0.85-1.03; p = 0.19) and its recurrence (RR = 0.93; 95% CI 0.85-1.02; p = 0.14). Subgroup analyses showed that probiotics as monotherapy do not have any beneficial effects on prevention of UTI (RR = 0.96; 95% CI 0.89-1.04; p = 0.31). However, the incidence of UTI is reduced if probiotics are used as adjuvant therapy to antibiotics (RR = 0.92; 95% CI 0.85-0.99; p = 0.02).

CONCLUSION

The present meta-analysis showed that probiotics did not have a beneficial effect in reducing the incidence or recurrence of UTI. Only a moderate efficacy was seen when a probiotic was used as adjuvant therapy to antibiotics.

摘要

背景

益生菌在降低儿童尿路感染(UTI)发生率方面的疗效尚未达成共识。本系统评价和荟萃分析旨在评估益生菌预防儿童 UTI 的疗效。

方法

本研究根据临床试验系统评价指南设计。两名独立评审员在 Medline、Embase、Web of Science 和 Scopus 电子数据库中进行了广泛搜索,截至 2016 年底。两名评审员独立评估合格研究的摘要并将其记录在数据提取表中。最后,报告了合并的相对风险(RR)及其 95%置信区间(95%CI)。

结果

共有 10 项研究的数据纳入本荟萃分析。益生菌治疗对 UTI 的发生率(RR=0.94;95%CI 0.85-1.03;p=0.19)及其复发(RR=0.93;95%CI 0.85-1.02;p=0.14)均无任何有益作用。亚组分析显示,益生菌单一疗法对预防 UTI 无任何有益作用(RR=0.96;95%CI 0.89-1.04;p=0.31)。然而,如果益生菌作为抗生素的辅助治疗,则 UTI 的发生率降低(RR=0.92;95%CI 0.85-0.99;p=0.02)。

结论

本荟萃分析表明,益生菌在降低 UTI 的发生率或复发方面没有有益作用。只有当益生菌作为抗生素的辅助治疗时,才显示出适度的疗效。

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