以統合分析探討益生菌於兒童抗生素相關性腹瀉之效益與安全性

Probiotics for the Efficacy and Safety of Pediatric Antibiotic-Associated Diarrhea - A Meta-Analysis

林美秀(Mei-Hsiu Lin) ； 黃玉芬(Yu-Fen Huang) ； 王郁雯(Yu-Wen Wang) ； 馮明珠(Ming-Chu Feng)

《高雄護理雜誌》 34卷3期 (2017/12) Pp. 1-12

https://doi.org/10.6692/KJN.201712_34(3).0001

摘要

背景：廣泛性抗生素的使用導致抗生素相關性腹瀉(AAD)發生率增加，益生菌對AAD 有保護效益，也有敗血症風險，要用於免疫系統未臻成熟的兒童，更須審慎評估。目的：探討益生菌對兒童抗生素相關性腹瀉之效益與安全性。方法：進入Cochrane Library、Pubmed/Medline 等資料庫以關鍵字抗生素、益生菌、antibiotics; probiotics; child or pediatric; diarrhea, diarrhoea or abdominal pain or gastrointestinal symptoms 進行系統搜尋，納入2006 年5 月至2016 年4 月統合分析及隨機控制試驗文獻。再以RevMan 5.3 做統合分析。結果：共6 篇文獻納入評析，結果發現使用抗生素的兒童若合併服用益生菌者，其AAD 發生率顯著降低；6 篇文獻中沒有因服用益生菌有不良反應的事件發生。結論/實務運用：抗生素治療24 小時內合併每天服用50 億CFUs 以上的益生菌對AAD 具保護效益。

關鍵字

兒童 ； 抗生素 ； 益生菌 ； 腹瀉

並列摘要

Background: Owing to the broad use of antibiotics, there was an elevated incidence of antibiotics-associated diarrhea(AAD). Probiotics had demonstrated the protective efficacy on AAD; it may increase the risk of sepsis in pediatrics because of immature immune system of children. Therefore, it should be carefully evaluated when used in pediatric patients. Objectives: To investigate the efficacy and safety of probiotics on antibiotics-associated diarrhea in children. Method: Searching Chinese keywords(抗生素、益生菌)、English keywords(antibiotics; probiotics; child or pediatric; diarrhea, diarrhoea or abdominal pain or gastrointestinal symptoms).We used the statistic of RevMan 5.3 on the references of randomized controlled trials from Cochrane library, Pubmed /Medline online libraries ect. for meta-analysis. Result: Six studies were critical appraised. We discovered that the children who received probiotics co-administration antibiotics had a significantly decreased incidence of AAD. No adverse events were reported among the children who received probiotics in all six studies. Conclusion/Implications for practice: Using of probiotics with daily dose more than 5 billions CFUs probiotics co-administration antibiotics within 24 hours would have protective effect against AAD.

並列關鍵字

pediatric ； antibiotics ； probiotics ； diarrhea

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