Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne 3052, Australia.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
World J Gastroenterol. 2017 Dec 7;23(45):7952-7964. doi: 10.3748/wjg.v23.i45.7952.
Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system. (Sb) and () were strongly recommended as adjunct treatment to oral rehydration therapy for gastroenteritis. could also be considered. Probiotics may be considered for prevention of (with the indicated strains): antibiotic-associated diarrhea (LGG or Sb); -induced diarrhea (Sb); nosocomial diarrhea (LGG); infantile colic () and as adjunct treatment of (Sb and others). Specific probiotics with a history of safe use in preterm and term infants may be considered in infants for prevention of necrotizing enterocolitis. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations apply well to Asia pacific countries. These need to be validated with local randomized-controlled trials.
在多个地区都有关于益生菌的推荐意见。本文提出了亚太地区儿科胃肠疾病的益生菌推荐意见。讨论了亚太国家肠道疾病的流行病学和临床模式。修订了该地区基于循证的推荐意见和随机对照试验。还考虑了文化方面、健康管理问题和经济因素。最终建议应用李克特量表进行批准，并使用 GRADE 系统进行评级。（Sb）和（）强烈推荐作为胃肠炎口服补液治疗的辅助治疗。也可以考虑。益生菌可用于预防（用指示菌株）：抗生素相关性腹泻（LGG 或 Sb）；艰难梭菌相关性腹泻（Sb）；医院获得性腹泻（LGG）；婴儿绞痛（）和辅助治疗（Sb 和其他）。对于预防坏死性小肠结肠炎，在早产儿和足月儿中具有安全使用史的特定益生菌可在婴儿中考虑。其他情况下的建议证据不足。尽管存在多种流行病学、社会经济和卫生系统状况，但类似的建议很好地适用于亚太国家。这些建议需要通过当地的随机对照试验进行验证。
