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[益生菌预防婴幼儿抗生素相关性腹泻的前瞻性随机对照研究]

[A prospective randomized controlled study on probiotics for the prevention of antibiotic-associated diarrhea in infants and young children].

作者信息

Zhang Su-Wei, Zhi Xian, Wang Meng-Yu, Shen Dong-Lin

机构信息

Department of Pediatric Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2024 Oct 15;26(10):1108-1114. doi: 10.7499/j.issn.1008-8830.2401129.

Abstract

OBJECTIVES

To evaluate the preventive effects of powder and tetragenous viable tablets on antibiotic-associated diarrhea (AAD) in infants and young children.

METHODS

Children under three years old admitted to the Department of Pediatrics, Affiliated Hospital of Xuzhou Medical University due to non-gastrointestinal infections and requiring antibiotic treatment from July to December 2023 were enrolled. The children were randomly divided into a control group (=47), a group (=70), and a group (=65) using a random number table method. The control group received antibiotics and symptomatic supportive treatment according to relevant clinical guidelines. In addition to the treatment given to the control group, the group and the group were respectively administered with powder and tetragenous viable tablets. Based on the duration of probiotic use (7 days, 14 days, and 21 days), the group was further divided into 7 d, 14 d, and 21 d subgroups, and similarly for the group. The incidence of AAD and ratio of cocci to bacilli in feces were compared among the groups after treatment.

RESULTS

The incidence rate of AAD in both the group and the group was lower than that in the control group (<0.017). The duration of AAD and the length of hospital stay were shorter in the and groups compared to the control group (<0.05). In the control group, the ratio of cocci to bacilli in feces on days 7, 14, and 21 was higher than on day 1 (<0.05). Within-group comparisons showed that the ratio of cocci to bacilli in feces on day 14 in the 14 d and 21 d groups were lower than on day 1 (<0.05); and the ratios on day 14 in the control group, 14 d group, 21 d group, 14 d group, and 21 d group were lower than on day 7 (<0.05). The ratios on day 21 in the control group and the 21 d group were lower than on days 7 and 14 (<0.05). Between-group comparisons indicated that on day 7, the ratios of cocci to bacilli in feces in the 7 d, 14 d, 21 d groups, and 7 d, 14 d, 21 d groups were all lower than in the control group (<0.05); on day 14, the ratios of cocci to bacilli in feces 14 d and 21 d groups were lower than in the control group and the 7 d group (<0.05).

CONCLUSIONS

Both and tetragenous viable can effectively improve gut microbiota and prevent the occurrence of AAD in infants and young children. Compared to short-term treatment, appropriately extending the duration of probiotic therapy can further improve the structure of gut microbiota.

摘要

目的

评估散剂和四联活菌片对婴幼儿抗生素相关性腹泻(AAD)的预防作用。

方法

选取2023年7月至12月因非胃肠道感染入住徐州医科大学附属医院儿科且需接受抗生素治疗的3岁以下儿童。采用随机数字表法将儿童随机分为对照组(n = 47)、A组(n = 70)和B组(n = 65)。对照组根据相关临床指南给予抗生素及对症支持治疗。A组和B组在给予对照组治疗的基础上,分别给予散剂和四联活菌片。根据益生菌使用时长(7天、14天和21天),A组进一步分为7d、14d和21d亚组,B组同理。比较治疗后各组AAD的发生率及粪便中球菌与杆菌的比例。

结果

A组和B组AAD的发生率均低于对照组(P < 0.017)。A组和B组AAD的病程及住院时间均短于对照组(P < 0.05)。对照组粪便中球菌与杆菌的比例在第7天、14天和21天高于第1天(P < 0.05)。组内比较显示,A组14d和21d亚组粪便中球菌与杆菌的比例在第14天低于第1天(P < 0.05);对照组、A组14d亚组、A组21d亚组、B组14d亚组和B组21d亚组第14天的比例低于第7天(P < 0.05)。对照组和A组21d亚组第21天的比例低于第7天和第14天(P < 0.05)。组间比较表明,第7天,A组7d、14d、21d亚组及B组7d、14d、21d亚组粪便中球菌与杆菌的比例均低于对照组(P < 0.05);第14天,A组14d和21d亚组粪便中球菌与杆菌的比例低于对照组和A组7d亚组(P < 0.05)。

结论

散剂和四联活菌片均可有效改善肠道微生物群,预防婴幼儿AAD的发生。与短期治疗相比,适当延长益生菌治疗时长可进一步改善肠道微生物群结构。

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