早期使用益生菌可能预防老年人（>65 岁）抗生素相关性腹泻：系统评价和荟萃分析。
Early use of probiotics might prevent antibiotic-associated diarrhea in elderly (>65 years): a systematic review and meta-analysis.
机构信息
The Center of Gerontology and Geriatrics, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Laboratory of Inflammatory bowel disease, the Center for Inflammatory Bowel Disease, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
出版信息
BMC Geriatr. 2022 Jul 6;22(1):562. doi: 10.1186/s12877-022-03257-3.
BACKGROUND
Antibiotic-associated diarrhea (AAD) is diarrhea associated with consuming antibiotics that cannot be explained by other causes. AAD prolongs admission time and increases mortality and financial costs. Elderly individuals are more prone to receive antibiotic treatment and develop AAD. The finding that living probiotic microorganisms decrease AAD incidence in adults (<65 years) has been clarified. However, it is controversial among elderly individuals.
METHODS
We aimed to explore whether probiotics could prevent AAD in elderly individuals. We searched three electronic databases (PubMed, EMBASE, and The Cochrane Library), and two reviewers independently screened and assessed the studies. RevMan5.4 software was used to perform a meta-analysis according to the PRISMA guidelines.
RESULTS
Eight RCTs of 4691 participants were included. We excluded two large studies because probiotics were used 48 hours after the first dose of antibiotics, and there was no effect. Subgroup analysis of 6 RCTs showed that probiotics given within two days of antibiotic treatment produced a lower AAD prevalence rate in elderly individuals.
CONCLUSION
We recommend that elderly individuals could be routinely distributed probiotics to prevent AAD development when receiving antibiotic treatment.
TRIAL REGISTRATION
The review was not registered.
背景
抗生素相关性腹泻（AAD）是指与使用抗生素相关的腹泻，无法用其他原因解释。AAD 会延长住院时间，增加死亡率和经济成本。老年人更容易接受抗生素治疗并发生 AAD。已经明确，活益生菌微生物可降低成年人（<65 岁）的 AAD 发生率。然而，这在老年人中存在争议。
方法
我们旨在探讨益生菌是否可以预防老年人的 AAD。我们搜索了三个电子数据库（PubMed、EMBASE 和 The Cochrane Library），并由两位审阅者独立筛选和评估研究。根据 PRISMA 指南，使用 RevMan5.4 软件进行荟萃分析。
结果
纳入了 8 项包含 4691 名参与者的 RCT。我们排除了两项大型研究，因为益生菌在抗生素首剂量后 48 小时使用，没有效果。6 项 RCT 的亚组分析表明，在抗生素治疗的两天内给予益生菌可降低老年人 AAD 的发生率。
结论
我们建议在接受抗生素治疗时，应常规向老年人分发益生菌以预防 AAD 的发生。
试验注册
该综述未进行注册。
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