Pathogen-Specific Effects of Probiotics in Children With Acute Gastroenteritis Seeking Emergency Care: A Randomized Trial
| Autor: | Stephen B Freedman, Yaron Finkelstein, Xiao Li Pang, Linda Chui, Phillip I Tarr, John M VanBuren, Cody Olsen, Bonita E Lee, Carla A Hall-Moore, Robert Sapien, Karen O’Connell, Adam C Levine, Naveen Poonai, Cindy Roskind, Suzanne Schuh, Alexander Rogers, Seema Bhatt, Serge Gouin, Prashant Mahajan, Cheryl Vance, Katrina Hurley, Elizabeth C Powell, Ken J Farion, David Schnadower |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Diarrhea medicine.medical_specialty Canada Emergency Medical Services medicine.disease_cause Placebo law.invention Probiotic Randomized controlled trial Lactobacillus rhamnosus Double-Blind Method law Internal medicine Rotavirus medicine Major Article Humans Child biology business.industry Lacticaseibacillus rhamnosus Probiotics Infant biology.organism_classification Lactobacillus helveticus Gastroenteritis Infectious Diseases Etiology Norovirus medicine.symptom business |
| Zdroj: | Clin Infect Dis |
| Popis: | Background It is unknown if probiotics exert pathogen-specific effects in children with diarrhea secondary to acute gastroenteritis. Methods Analysis of patient-level data from 2 multicenter randomized, placebo controlled trials conducted in pediatric emergency departments in Canada and the United States. Participants were 3–48 months with >3 diarrheal episodes in the preceding 24 hours and were symptomatic for Results Pathogens were identified in specimens from 59.3% of children (928/1565). No pathogen groups were less likely to experience an MVS score ≥9 based on treatment allocation (test for interaction = 0.35). No differences between groups were identified for adenovirus (adjusted relative risk [aRR]: 1.42; 95% confidence interval [CI]: .62, 3.23), norovirus (aRR: 0.98; 95% CI: .56, 1.74), rotavirus (aRR: 0.86; 95% CI: .43, 1.71) or bacteria (aRR: 1.19; 95% CI: .41, 3.43). At pathogen-group and among individual pathogens there were no differences in diarrhea duration or the total number of diarrheal stools between treatment groups, regardless of intervention allocation or among probiotic sub-groups. Among adenovirus-infected children, those administered the L. rhamnosus R0011/L. helveticus R0052 product experienced fewer diarrheal episodes (aRR: 0.65; 95% CI: .47, .90). Conclusions Neither probiotic product resulted in less severe disease compared to placebo across a range of the most common etiologic pathogens. The preponderance of evidence does not support the notion that there are pathogen specific benefits associated with probiotic use in children with acute gastroenteritis. Clinical Trials Registration NCT01773967 and NCT01853124. |
| Databáze: | OpenAIRE |
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