博氏酵母菌治疗难治性复发性艰难梭菌感染的文献综述

Rachel Warila, R. Hoover
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引用次数: 1

摘要

目的:评价博氏梭菌治疗复发性难辨梭菌感染的疗效。方法:符合条件的文献包括复发性艰难梭菌感染患者的博氏梭菌。检查的主要终点是感染的临床消退,随访期间没有进一步复发。结果:6项研究符合纳入标准。一份病例报告显示,一名患者的复发得到缓解,一项实验性试验显示,接受博氏弓形虫治疗的患者的复发率有下降的趋势(85%的患者不再复发)。两项随机对照试验发现,与安慰剂相比,博氏弓形虫的复发率显著降低(34.6% vs 64.7%, P=0.04;16.7% vs 50%, P=0.05)。一项荟萃分析确定了博氏梭菌在减少复发方面的显著疗效(RR 0.59, 95% CI 0.35-0.98),而另一项荟萃分析得出结论,没有足够的证据推荐益生菌治疗艰难梭菌感染。结论:复发性艰难梭菌感染,单药治疗难治性患者可考虑鲍氏梭菌。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Literature Review of Saccharomyces boulardii in the Treatment of Refractory Recurrent Clostridium difficile Infection
Objective: To evaluate the efficacy of S. boulardii for the treatment of recurrent C. difficile infections. Methods: Eligible articles included S. boulardii in patients with recurrent C. difficile infection. The primary endpoint examined was clinical resolution of infection with no further recurrences during follow-up. Results: Six studies met inclusion criteria. A case report showed resolution of recurrences in one patient, and an experimental trial showed a trend towards decreased recurrences in patients receiving S. boulardii (85% no further recurrences). Two randomized controlled trials found a significant decrease in recurrences for S. boulardii versus placebo (34.6% vs 64.7%, P=0.04; 16.7% vs 50%, P=0.05). One meta-analysis determined significant efficacy for S. boulardii in reducing relapses (RR 0.59, 95% CI 0.35-0.98), while another concluded there was insufficient evidence to recommend probiotics for C. difficile infection. Conclusions: S. boulardii may be considered for patients with recurrent C. difficile infection, refractory to antibiotic regimens alone.
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