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Probiotics for the prevention of pediatric antibiotic-associated diarrhea (Review)

Author(s)BC Johnston; AL Supina; M Ospina; S Vohra
AbstractIt is premature to routinely recommend probiotics for the prevention of pediatric antibiotic-associated diarrhea (AAD)

Studies of probiotics for the prevention of pediatric AAD.
Ten studies were reviewed and provide the best evidence we have. Study quality was mostly good overall. The studies tested 1986 children (aged 0 to 18 years) who were receiving probiotics co-administered with antibiotics to prevent AAD. The subjects received probiotics (Lactobacilli spp., Bifidobacterium spp., Streptococcus spp., or Saccharomyces boulardii alone or in combination), placebo (fake pills), other treatments thought to prevent AAD (i.e. diosmectite or infant formula) or no treatment. The studies were short term and ranged in length from 15 days to 3 months.

What is AAD and could probiotics work to prevent AAD?
AAD occurs when antibiotics disturb the natural balance of "good" and "bad" bacteria in the intestinal tract causing harmful bacteria to sometimes multiply beyond their normal numbers. The symptoms of AAD may include frequent watery bowel movements and crampy abdominal pain. Probiotics are dietary supplements containing potentially beneficial bacteria or yeast. Probiotics are thought to restore the natural balance of bacteria in the intestinal tract.

What did the studies show?
An analysis that included only patients who completed the studies showed that probiotics may be effective for preventing AAD. However, a more conservative analysis that counted study drop-outs as treatment failures did not show any differences between probiotic and comparison groups.

How safe are probiotics?
Probiotics were generally well tolerated and side effects occurred infrequently.

What is the bottom line?
Although current data are promising, there is insufficient evidence to routinely recommend the use of probiotics for the prevention of pediatric AAD.
Date of publishing04/18/2007
Date of last review by us07/28/2007
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