Risk and Protective Factors for Gastrointestinal Symptoms associated with Antibiotic Treatment in Children: A Population Study.

Autor:	Baù M; Department of Pediatric, Ospedale 'F. Del Ponte', University of Insubria, Varese, Italy., Moretti A; Department of Pediatric, Ospedale 'F. Del Ponte', University of Insubria, Varese, Italy., Bertoni E; Department of Pediatric, Ospedale 'F. Del Ponte', University of Insubria, Varese, Italy., Vazzoler V; Department of Statistic, University of Padua, Padua, Italy., Luini C; Department of Pediatric, Ospedale 'F. Del Ponte', University of Insubria, Varese, Italy., Agosti M; Department of Pediatric, Ospedale 'F. Del Ponte', University of Insubria, Varese, Italy., Salvatore S; Department of Pediatric, Ospedale 'F. Del Ponte', University of Insubria, Varese, Italy.
Jazyk:	angličtina
Zdroj:	Pediatric gastroenterology, hepatology & nutrition [Pediatr Gastroenterol Hepatol Nutr] 2020 Jan; Vol. 23 (1), pp. 35-48. Date of Electronic Publication: 2020 Jan 08.
DOI:	10.5223/pghn.2020.23.1.35
Abstrakt:	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. Competing Interests: Conflict of Interest: The authors have no financial conflicts of interest. (Copyright © 2020 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition.)
Databáze:	MEDLINE
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