A retrospective study of probiotics for the treatment of children with antibiotic-associated diarrhea

Effect of probiotic yogurt on antibiotic-associated diarrhea among pediatric patients; randomized controlled trial

BACKGROUND

Diarrhea is a common unfavorable consequence of antibiotics. Probiotic yogurt is equally effective as probiotic capsules, so it may provide a simple and cost-effective means of preventing antibiotic-associated diarrhea (AAD). The study aimed to evaluate the effect of probiotic yogurt on AAD among pediatric patients.

MATERIALS AND METHODS

The randomized controlled trial design was adopted in this investigation, with a post-test-only control group. Data were obtained from 244 pediatric patients on antibiotics who were admitted to the hospital and included in the trial via full enumeration sampling. Selected subjects were randomly assigned to experimental (n = 122) or control (n = 122) groups. The experimental group received probiotic yogurt for five days, whereas the control group received standard care. The incidence and severity of diarrhea on the fifth day of the intervention were used to determine the study's results. The trial was registered with the Clinical Trials Registry - India (CTRI). Consolidated Standards of Reporting Trials (CONSORT) were followed. Descriptive and inferential statistics were used for data analysis. Statistical software was used for descriptive and inferential analysis.

RESULTS

AAD occurred in 13.90% and 36.88% of individuals in the experimental and control groups, respectively (odds ratio: p: 0.27:0.001). Further, yogurt intervention was found to be effective in terms of increasing the consistency of the stool (p. 001*), decreasing the duration and onset of diarrhea (P ≤ .001*), reducing the frequency and amount of loose stool (P ≤ .001*), reducing the urgency of defecation (P ≤ .001*), the presence of abdominal discomfort (P ≤ .001*), and dehydration (P ≤ .001*).

CONCLUSION

In hospitals, antibiotics are commonly prescribed, and the most common side effect of medications is diarrhea. Probiotic yogurt guards against this side effect of antibiotics. Nurse practitioners need to understand the value of probiotic yogurt as a preventive measure that could save children's lives.

Effect of a Multispecies Probiotic Mixture on the Growth and Incidence of Diarrhea, Immune Function, and Fecal Microbiota of Pre-weaning Dairy Calves

The effects of different doses of a multispecies probiotic (MSP) mixture on growth performance, the incidence of diarrhea rate and immune function, and fecal microbial diversity and structure were evaluated in pre-weaning Holstein dairy calves at WK2, WK4, WK6, and WK8. Forty Chinese Holstein female newborn calves were randomly assigned to four treatments with 10 calves in each group, C (control group), T1 (0.5 g MSP/calf/day, T2 (1 g MSP/calf/day), and T3 (2 g MSP/calf/day) groups. The experimental period was 56 days. Feed intake and health scoring were recorded every day until the end of the experiment. Fecal contents and blood samples were sampled at WK2, WK4, WK6, and WK8. Growth performance, incidence of diarrhea, and total serum concentrations (IgA, IgG, and IgM) were analyzed. Bacterial 16S rRNA and fungal ITS genes were high-throughput sequenced for fecal microbiota. The relationships among the populations of the principal fecal microbiota at WK2 and the growth performance or serum immunoglobulin concentrations were analyzed using Pearson's rank correlation coefficients. The MSP supplementation reduced the incidence of diarrhea in the first 4 weeks of life, and serum IgA, IgG, and IgM concentrations increased between WK2 and WK8 in the T3 group. There was an increase in growth performance and reduction in the incidence of diarrhea until WK4 after birth in T3 group, compared with the control, T1, and T2 groups. The results of fecal microbiota analysis showed that Firmicutes and Bacteroides were the predominant phyla, with Blautia, Ruminococcaceae_UCG-005, norank_f__Muribaculaceae, Bacteroides, Subdoligranulum, and Bifidobacterium being the dominant genera in calf feces. Aspergillus, Thermomyces, and Saccharomyces were the predominant fungal phyla. Compared with the control, in T1 and T2 groups, the MSP supplementation reduced the relative abundance of Bacteroidetes and increased the relative abundance of Bifidobacterium, Lactobacillus, Collinsella, and Saccharomyces at WK2 in group T3. Thus, the fecal microbial composition and diversity was significantly affected by the MSP mixture during the first 2 weeks of the calves' life. MSP mixtures reduced the incidence of diarrhea in pre-weaning calves (during the first 4 weeks of life). There was a significant improvement in growth performance, reduction in calf diarrhea, balance in the fecal microbiota, and an overall improvement in serum immunity, compared with the control group. We, therefore, recommend adding 2 g/day of multispecies probiotic mixture supplementation in diets of dairy calves during their first 4 weeks of life before weaning.

Effect of Simulated Gastrointestinal Tract Conditions on Survivability of Probiotic Bacteria Present in Commercial Preparations

Probiotics are recommended, among others, in the diet of children who are under antibiotic therapy, or that suffer from food allergies or travel diarrhea, etc. In the case of toddlers taking probiotic preparations, it is highly recommended to first remove the special capsule, which normally protects probiotic strains against hard conditions in the gastrointestinal tract. Otherwise, the toddler may choke. This removal can impair probiotic survival and reduce its efficacy in a toddler's organism. The aim of this study was to evaluate the survivability of five strains of lactic acid bacteria from the commercial probiotics available on the Polish market under simulated conditions of the gastrointestinal tract. Five probiotics (each including one of these strains: Bifidobacterium BB-12, Lactobacillus (Lb.) rhamnosus GG, Lb. casei, Lb. acidophilus, Lb. plantarum) were protective capsule deprived, added in a food matrix (chicken-vegetable soup) and subjected under simulated conditions of the gastric and gastrointestinal passage. Strain survivability and possibility to growth were evaluated. Obtained results showed that, among all analyzed commercial probiotic strains, the Lb. plantarum was the most resistant to the applied conditions of the culture medium. They showed a noticeable growth under both in vitro gastric conditions at pH 4.0 and 5.0, as well as in vitro intestinal conditions at all tested concentrations of bile salts.