Lactobacillus GG in the Prevention of Antibiotic-Associated Diarrhea in the Pediatric Intensive Care Unit: A Prospective Randomized, Double-Blind Placebo Controlled Intervention.
Allison Chung, Mukul Sehgal, Cristina Gavrilita, Sheryl Falkos, Rosa Vidal
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引用次数: 0
Abstract
Objective: The objective of this study was to assess the efficacy of lactobacillus GG (LGG) to prevent antibiotic-associated diarrhea (AAD) in the pediatric intensive care unit (PICU).
Methods: This was a prospective randomized, double-blind, placebo-controlled pilot trial in an academic PICU over 1 year. Patients ≤ 17 years who required antibiotic therapy ≥ 72 hours were randomly assigned to receive placebo or LGG. Exclusion criteria included antibiotics ≥ 48 hours prior, prior probiotics, pre-existing diarrhea, laxative therapy, immunocompromise, and gastrointestinal (GI) disorders. LGG (30 × 109 colony forming units) or a matching placebo capsule was administered twice daily for the duration of antibiotic therapy. Diarrhea was defined as 3 or more loose stools in 24 hours.
Results: A total of 36 patients were enrolled with 19 patients eligible for final analysis; 10 in the LGG group and 9 in the placebo group. Median age and weight of LGG vs placebo groups were 0.4 (0.17-1.42) vs 0.86 (1.21-10.92) years, p = 0.48, and 6 (3.4-9.9) vs 9.8 (3.71-39.6) kg, p = 0.31, respectively. Antibiotic associated diarrhea was experienced in 30% vs 55.5% of patients in the LGG groups vs placebo (p = 0.375), respectively. The median PICU length of stay for the patients with AAD was 6 days compared with 7.5 days in placebo group (p = 0.033). The RR ratio for AAD when using LGG was 0.59 (95% CI, 0.21-1.6). No adverse events were reported or attributed to LGG.
Conclusion: Results of this pilot study indicate that LGG is safe and could potentially reduce the incidence of AAD in the critically ill pediatric patients at this academic institution. Our findings suggest clinicians should consider the use of LGG in appropriate PICU patients.
期刊介绍:
The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.