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Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science

Specialty

Pediatrics

Advisor

Dr. Nancy Reid

Abstract

Importance: In healthy pediatric patients that are prescribed antibiotics, does the concurrent use of probiotics prevent antibiotic-associated diarrhea (AAD)?

Objective: The importance of this article is to review the concurrent use of antibiotics and probiotics in preventing antibiotic-associated diarrhea in healthy pediatric patients.

Evidence Review: A PubMed and Cochrane Database of Systematic Reviews search was performed using the advanced search link “probiotics”, “pediatrics”, “prevention”, and “antibiotic-associated diarrhea” were used in the advanced search builder. Filters were also selected including: “free full text”, “humans”, “publication dates within the past 5 years”, “English” language, and ages “birth-18years”. The “best match” sorting feature was selected. This combination limited the search more specifically.

Findings: Probiotics have been studied to evaluate the reduction and prevention of AAD and they are proven effective and safe. Different probiotics are more efficacious than others. the randomized, placebo-controlled study, n=70 (36 placebo and 34 probiotic), yogurt, 2-100g tubs a day, with probiotics lactobacillus rhamnosus (LGG), lactobacillus acidophilus and Bifidobacterium lactis were given and found to have a reduction in diarrhea. After 5 days to 12 weeks of follow-up after taking antibiotics and concurrent probiotics, the incidence of AAD in the probiotic group was 8% and the placebo or no-treatment group was 19%. For the 6352 subjects, the relative risk was 0.45, 95% confidence interval was 0.36 to 0.56; P

Conclusion and Relevance: Pediatric patients that received specific probiotics had prevention or reduction of antibiotic-associated diarrhea. This outcome is favorable and would be clinically important in reducing hospitalizations, clinic visits and missed days of school and work. These results can provide support for recommending probiotic use with concurrent antibiotic use. Probiotics have different functions including producing antimicrobial substances, function as a barrier, block and compete with other bacteria in the gastrointestinal tract and blocking inflammatory factors that affect the immune system.

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