Пробиотики.

[dr.Ira]

Conclusions: This probiotics mixture reduced the severity of diarrhea and length of hospital stay in children with acute diarrhea. In addition to restoring beneficial intestinal flora, probiotics may enhance host protective immunity such as down-regulation of pro-inflammatory cytokines and up-regulation of anti-inflammatory cytokines.
Posted: 03/04/2010; Pediatr Infect Dis J. 2010;29(2):135-138
Полностью здесь [Ссылки доступны только зарегистрированным пользователям ]

[Gratis]

Вот еще одна статья об эффективности пробиотиков.
[Ссылки доступны только зарегистрированным пользователям ]

[Gratis]

Enteral supplementation of probiotics reduces the risk of severe NEC and mortality in preterm infants. A large randomized controlled trial is required to investigate the benefit and safety profile of probiotics supplementation in ELBW infants. Абстракт:[Ссылки доступны только зарегистрированным пользователям ]

[Gratis]

В продолжении темы Clinical Report: Probiotics and Prebiotics in Pediatrics
PDF full: [Ссылки доступны только зарегистрированным пользователям ]

[dr.Ira]

Тут выдержки из беседы с Dr. Dan W. Thomas - одним из авторов работы ссылку на которую привел коллега.

Medscape ...what would you suggest primary care providers advise parents who choose to bottle-feed? Should infant formula supplemented with probiotics be recommended?
Dr. Thomas: No one can answer this question at this time. The health benefits of feeding infant formula containing probiotics and/or prebiotics are unproven. In essence, this report challenges industry and healthcare researchers to conduct high-quality, evidence-based studies to answer these questions.

Medscape:And what about advice to parents of older children who would like to give probiotics to their child?
Dr. Thomas: Outside of the specific situations outlined in this report where there is evidence of benefit, the answer to this question, too, is relatively unknown and will have to await further research. While the results indicate that there is modest benefit with use of probiotics to prevent AGE in infants and children, the available data do not support routine use to prevent nosocomial rotavirus diarrhea in children attending daycare.


Medscape: What does the report say about use of probiotics in the prevention and treatment of antibiotic-associated diarrhea?
Dan W. Thomas However, there have been no published RCTs examining probiotics for the treatment of antibiotic-associated diarrhea in children, including Clostridium difficile antibiotic-associated diarrhea, and therefore their use presently cannot be recommended for pediatric patients.

Medscape: Can you discuss the report's recommendations regarding use of probiotics in other GI conditions such as infantile colic and irritable bowel syndrome?
Dan W. Thomas While the results were encouraging, finding less crying within 1 week of initiation of Lactobacillus reuteri when compared with simethicone, probiotics cannot yet be routinely recommended ...Studies of efficacy in treating constipation have been less positive, however, and they are not recommended at this time for treatment of this condition in children.

Medscape: What about use in more serious GI conditions such as inflammatory bowel disease (IBD) or necrotizing enterocolitis (NEC)?
Dan W. Thomas more research is needed and probiotics cannot be routinely recommend at this time. At this time, their use cannot be recommended for children with Crohn disease.
There is evidence to support the use of probiotics to prevent NEC in preterm infants weighing more than 1000 g at birth.[5] However, there remain many unanswered questions over the use of probiotics for prevention of NEC, including overall safety. Further study is recommended before routine utilization of probiotics for this purpose can be recommended.

Medscape:The clinical report also discussed use of probiotics for non-gastrointestinal conditions, particularly atopic disease. Can you share some of these recommendations?
Dan W. Thomas That position was reiterated in a 2010 review that concluded that there was not enough evidence to support the use of probiotics, prebiotics, or synbiotics in the prevention or treatment of allergic dermatitis in children.[7]

Medscape:The clinical report also discussed use of these agents in prevention and management of extraintestinal, primarily respiratory, infection. Can you describe these results?
Dan W. Thomas No studies have found a benefit from administration of probiotics to treat these infections.

[anikaa]

А я вот обратила внимание на другие выдержки

Medscape: Dr. Thomas....... what is the role of these agents in prevention and treatment of acute gastroenteritis (AGE)?

Dr. Thomas: While the results indicate that there is modest benefit with use of probiotics to prevent AGE in infants and children, the available data do not support routine use to prevent nosocomial rotavirus diarrhea in children attending daycare. Rotavirus vaccine is likely to be a much more effective agent in preventing rotavirus infection although there may be special circumstances, such as long-term care facilities, where use of probiotics may be useful in prevention. In the treatment of AGE, however, the data are positive. There is evidence from well-conducted RCTs to support the use of probiotics, specifically LGG, in the management of acute infectious diarrhea. Probiotics have been found to shorten the duration of diarrhea by about 1 day and to decrease the number of diarrheal stools. They also shorten the time necessary for intravenous hydration when this is required. Probiotics seem to be more effective when given early in the course of diarrhea and are most effective in healthy infants and young children with watery diarrhea due to viral gastroenteritis, such as rotavirus, but not invasive bacterial infections.

Поскольку ротавирусной вакцины в РФ нет - ИМХО от этого не стОит отмахиваться.

Medscape: What does the report say about use of probiotics in the prevention and treatment of antibiotic-associated diarrhea?

Dr. Thomas: Prevention of diarrhea due to antibiotic use is another area where a meta-analysis of RCTs indicates a benefit from probiotics.[1] In most of the studies, a probiotic was initiated at the same time as the antibiotic, resulting in a substantial reduction in development of diarrhea. Approximately 1 in 7 cases of antibiotic-associated diarrhea was prevented by the use of a probiotic. However, there have been no published RCTs examining probiotics for the treatment of antibiotic-associated diarrhea in children, including Clostridium difficile antibiotic-associated diarrhea, and therefore their use presently cannot be recommended for pediatric patients.

Понятно, что лечить ААД пробиотиками не нужно. А вот профилактика- с учетом того, как обстоят дела с диагностикой и лечением той же клостридиальной инфекции ....

Собственно я поняла эту публикацию так:

Профилактика ААД -возможно.
Лечение ротавирусной инфекции- возможно .
Всё остальное: атопии, ВЗК, лечение ААД, бактериальные поносы, профилактика ОРВИ , просто так в смеси- пока нет.

[luidhen]

Probiotic Improves Colic in Breastfed Infants

By Will Boggs, MD

NEW YORK (Reuters Health) Sep 26 - The probiotic Lactobacillus reuteri DSM 17938 improves colic in infants who are exclusively or predominantly breastfed, a new study shows.

"Given the lack of effective therapy for infantile colic and the generally good safety profile of probiotics in otherwise healthy populations, the use of L. reuteri DSM 17938 could be discussed with caregivers," Dr. Hania Szajewska from the Medical University of Warsaw in Poland told Reuters Health by email.

A number of therapies for colic have been tried (modified formulas, herbal teas, music, and the like), but none so far has been proven conclusively to be effective.

Encouraged by a recent double-blind randomized trial that showed improvement of colic symptoms in breastfed infants, Dr. Szajewska and colleagues compared the effectiveness of L. reuteri DSM 17938 with placebo in the treatment of 80 breastfed infants with infantile colic.

Significantly more infants in the probiotic group than in the placebo group experienced treatment success (a reduction in the daily average crying time of at least 50%) beginning at day 7 and continuing throughout the 28-day study.

At day 14, for instance, 30 of 40 kids given probiotics experienced treatment success versus only 7 of 40 in the placebo group, for a number needed to treat of 2.

Median duration of daily crying was also significantly improved by probiotic treatment at all time points after baseline.

Secondary outcomes (parental perception of colic severity and family quality of life) were also significantly better in the probiotic group than in the placebo group.

According to the September 17th report in The Journal of Pediatrics, there were no adverse events associated with either treatment.

The researchers say that possible explanations for these improvements include L. reuteri's effects on gut motility and function, colonic sensory nerves, colon contractile activity, and pain perception, as well as possible anti-inflammatory effects.

However, as Dr. Szajewska notes, "The mechanism of action of L. reuteri for treating infantile colic has yet to be elucidated."

"The necessity of treating this self-limiting condition may be questioned," the authors conclude. "However, if one wants to modify the natural history of infantile colic, the use of L. reuteri DSM 17938 could be discussed with caregivers."

"Future studies," they add, "should clarify the role of L. reuteri DSM 17938 in the management of infantile colic in formula-fed infants."

The study was funded by the Medical University of Warsaw, which had received a donation from BioGaia AB, the manufacturer of L. reuteri DSM 17938.

SOURCE: [Ссылки доступны только зарегистрированным пользователям ]

J Pediatr 2012.[Ссылки доступны только зарегистрированным пользователям ]

ЗЫ: получила с рассылкой.

[Kreebis]

Даже в UpToDate пробиотикам посвящена целая глава. [Ссылки доступны только зарегистрированным пользователям ]
Они рекомендуют Saccharomyces boulardii добавлять к эрадикационной терапии H.pylori. При этом для большинства американских врачей Uptodate чуть ли не последняя инстанция. Кто бы мог подумать о таком еще несколько лет назад... (я имею в виду появление успешных триалов по пробиотикам на страницах JAMA, на медскейпе, и в Самом Аптудейте))) т.е. evidence по некоторым заболеваниям давно был, но в последние годы прямо прорыв, имхо

[NatashkaNew]

О пробиотиках для лечения и профилактики инфекционных болезней - обзор на украинском (американское сообщество диетологии) [Ссылки доступны только зарегистрированным пользователям ]

[ОльгаШа]

В пандан

Сообщение от eduardshraibman

для тех, кто не дождался перевода статьи на азербайджанский ,армянский,узбекский и другие языки, может почитать оригинал [Ссылки доступны только зарегистрированным пользователям ] или заключение [Ссылки доступны только зарегистрированным пользователям ]