Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
School of Medicine, University J.J Strossmayer, Osijek, Croatia.
Acta Paediatr. 2018 Jun;107(6):927-937. doi: 10.1111/apa.14270. Epub 2018 Apr 16.
The use of probiotics has been covered by many guidelines, position papers and evidence-based recommendations, but few have referred to specific patient groups or clinical indications. This review summarises recommendations and scientifically credited guidelines on the use of probiotics for children with selected clinical conditions and provides practice points.
An expert panel was convened by the European Paediatric Association in June 2017 to define the relevant clinical questions for using probiotics in paediatric health care and review and summarise the guidelines, recommendations, position papers and high-quality evidence.
The panel found that specific probiotic strains were effective in preventing antibiotic-associated and nosocomial diarrhoea, treating acute gastroenteritis and treating infantile colic in breastfed infants. However, special caution is indicated for premature infants, immunocompromised and critically ill patients and those with central venous catheters, cardiac valvular disease and short-gut syndrome. This review discusses the safety of using probiotics in selected groups of paediatric patients and the quality of the available products providing practice points based on proved findings.
Efficacy of probiotics is strain specific. Their benefits are currently scientifically proven for their use in selected clinical conditions in children and not recommended for certain patient groups.
益生菌的使用已被许多指南、立场文件和循证建议涵盖,但很少有指南针对特定的患者群体或临床指征。本综述总结了关于在选定临床情况下使用益生菌的建议和经过科学认可的指南,并提供了实践要点。
欧洲儿科学会于 2017 年 6 月召集了一个专家小组,以确定在儿科保健中使用益生菌的相关临床问题,并审查和总结指南、建议、立场文件和高质量证据。
专家组发现,特定的益生菌菌株在预防抗生素相关性和医院获得性腹泻、治疗急性胃肠炎和治疗母乳喂养婴儿的婴儿绞痛方面有效。然而,对于早产儿、免疫功能低下和危重症患者以及患有中心静脉导管、心脏瓣膜病和短肠综合征的患者,需要特别小心。本综述讨论了在选定的儿科患者群体中使用益生菌的安全性以及现有产品的质量,并根据已证实的发现提供了实践要点。
益生菌的疗效具有菌株特异性。目前已证明它们在儿童特定临床情况下使用具有疗效,但不建议在某些患者群体中使用。