Профилактика и лечение антибиотик-ассоциированной диареи у детей раннего возраста

Abstract

Diarrhea that occurs during treatment with antibiotics and has no other apparent reasons is defined as antibiotic-associated diarrhea (AAD). The purpose of the study was to investigate the efficacy and safety of probiotics containing Lactobacillus rhamnosus Rosell-11, Lactobacillus acidophilus Rosell-52 for the prevention and treatment of antibiotic-associated diarrhea in children aged 0-3 years. A randomized, single-center study was conducted that included 60 children, both male and female, aged 1-36 months who have received parenteral antibiotic therapy during at least 7 days. All children were divided into 2 groups: treatment group (I) consisted of 30 children who have administered probiotics (since the first day of treatment), and control group (II) of 30 children who have received standard treatment without probiotics. Episodes of diarrhea, their duration and time of origin were recorded. Severity of dyspeptic symptoms was expressed in points. The high incidence (40%) of AAD in children aged 0-3 years determines the need for prevention with the use of probiotics. The most significant risk factors were the use of artificial lung ventilation (OR = 23.00, 95% CI 2.20-565.25), hospital stay longer than 10 days (OR = 6.00, 95% CI 1.30-29.67), cephalosporin-aminoglycoside combinations (OR = 6.42, 95% CI 1.23-36.74). Administration of probiotic containing Lactobacillus rhamnosus Rosell-11, Lactobacillus acidophilus Rosell-52 decreased the odds of AAD onset nearly threefold, its duration - nearly by half, as wells as reduced severity of clinical symptoms of diarrhea, so that the probiotic can be recommended as a preventive and therapeutic agent.