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Quantitative Polymerase Chain Reaction-based Analyses of Murine Intestinal Microbiota After Oral Antibiotic Treatment
Published on: November 17, 2018
Risk and Protective Factors for Gastrointestinal Symptoms associated with Antibiotic Treatment in Children: A
Mario Baù1, Alex Moretti1, Elisabetta Bertoni1
1Department of Pediatric, Ospedale "F. Del Ponte", University of Insubria, Varese, Italy.
Insights
Antibiotic-associated diarrhea (AAD) affects 20.4% of children, with higher risks in younger children and specific infections. Probiotic supplementation, particularly Lactobacillus rhamnosus GG and L. reuteri, effectively reduced AAD and abdominal pain.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiome Research
Background:
- Gastrointestinal symptoms are common complications of antibiotic therapy in children.
- The incidence and risk factors for these symptoms, including antibiotic-associated diarrhea (AAD), are not well-established.
- Understanding protective factors is crucial for managing pediatric antibiotic use.
Purpose of the Study:
- To determine the incidence, risk factors, and protective conditions associated with gastrointestinal symptoms in children receiving antibiotic treatment.
- To evaluate the efficacy of probiotic supplementation in preventing and managing AAD and associated symptoms.
Main Methods:
- Prospective enrollment of inpatient children undergoing antibiotic treatment.
- Recording of antibiotic details, probiotic use, and gastrointestinal symptoms at baseline, 2, and 4 weeks.
- Definition of AAD as at least 3 loose/liquid stools within 14 days of antibiotic initiation.
Main Results:
- AAD occurred in 20.4% of children, with increased risk in those younger than 3 years, with lower respiratory or urinary tract infections, receiving intravenous antibiotics, or with prior AAD.
- Abdominal pain and constipation were also observed, with specific risk factors identified for each.
- Probiotic supplementation, including Lactobacillus rhamnosus GG (LGG) and L. reuteri, significantly reduced the incidence of AAD and abdominal pain.
Conclusions:
- Antibiotic-associated diarrhea affects a significant proportion of pediatric patients, with identifiable risk factors.
- Probiotic interventions, specifically LGG and L. reuteri, demonstrate a protective effect against AAD and related abdominal discomfort.
- Targeted probiotic use may be a valuable strategy in mitigating gastrointestinal side effects of antibiotics in children.
Purpose:
Gastrointestinal symptoms are often related to antibiotic treatment. Their incidence, risk and protective conditions in children are not well defined and represent the aims of this study.
Methods:
We prospectively enrolled inpatient children submitted to antibiotic treatment. Indication, type, dose and duration of treatment, probiotic supplementation and gastrointestinal symptoms were recorded at recruitment, after two and four weeks. Antibiotic-associated diarrhea (AAD) was defined as the presence of at least 3 loose/liquid stools within 14 days from antibiotic onset.
Results:
AAD occurred in 59/289 (20.4%) of patients, with increased risk in children younger than 3 years (relative risk [RR]=4.25), in lower respiratory (RR=2.11) and urinary infections (RR=3.67), intravenous administration (RR=1.81) and previous AAD episodes (RR=1.87). Abdominal pain occurred in 27/289 (9.3%), particularly in children >6 years (RR=4.15), with previous abdominal pain (RR=7.2) or constipation (RR=4.06). Constipation was recorded in 23/289 (8.0%), with increased risk in children having surgery (RR=2.56) or previous constipation (RR=7.38). Probiotic supplementation significantly reduced AAD (RR=0.30) and abdominal pain (RR=0.36). Lactobacillus rhamnosus GG (LGG) and L. reuteri significantly reduced AAD (RR=0.37 and 0.35) and abdominal pain (RR=0.37 and 0.24).
Conclusion:
AAD occurred in 20.4% of children, with increased risk at younger age, lower respiratory and urinary tract infections, intravenous treatment and previous AAD. LGG and L. reuteri reduced both AAD and associated abdominal pain.
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