Lactobacillus GG in the Prevention of Antibiotic-Associated Diarrhea in the Pediatric Intensive Care Unit: A Prospective Randomized, Double-Blind Placebo Controlled Intervention.

Q2 Medicine
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.

GG乳杆菌在预防儿科重症监护室抗生素相关性腹泻中的作用:一项前瞻性、随机、双盲安慰剂对照干预。
目的:本研究的目的是评估乳酸菌GG (LGG)预防儿科重症监护病房(PICU)抗生素相关性腹泻(AAD)的疗效。方法:这是一项前瞻性、随机、双盲、安慰剂对照的PICU临床试验,为期1年。≤17岁且需要抗生素治疗≥72小时的患者被随机分配接受安慰剂或LGG。排除标准包括≥48小时前使用抗生素、既往使用益生菌、既往腹泻、泻药治疗、免疫功能低下和胃肠道疾病。在抗生素治疗期间,每天两次给予LGG (30 × 109菌落形成单位)或相应的安慰剂胶囊。腹泻定义为24小时内3次或更多稀便。结果:共纳入36例患者,其中19例符合最终分析条件;LGG组10例,安慰剂组9例。LGG组和安慰剂组的中位年龄和体重分别为0.4(0.17-1.42)和0.86(1.21-10.92)岁,p = 0.48; 6(3.4-9.9)和9.8 (3.71-39.6)kg, p = 0.31。LGG组与安慰剂组抗生素相关性腹泻发生率分别为30%和55.5% (p = 0.375)。AAD患者PICU的中位住院时间为6天,而安慰剂组为7.5天(p = 0.033)。使用LGG时,AAD的RR比为0.59 (95% CI, 0.21-1.6)。没有不良事件报告或归因于LGG。结论:本初步研究结果表明,LGG是安全的,可能会降低该学术机构危重儿科患者AAD的发病率。我们的研究结果提示临床医生应考虑在适当的PICU患者中使用LGG。
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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
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.
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