Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients-A Systematic Review and Meta-Analysis.
Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Outpatients-A Systematic Review and Meta-Analysis.
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DOI：
10.3390/antibiotics6040021
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发表时间：
2017-10-12
期刊：
影响因子：
--
通讯作者：
Aabenhus R
中科院分区：
文献类型：
--
作者：
Blaabjerg S;Artzi DM;Aabenhus R
使用抗生素的常见副作用是腹泻。益生菌是活的微生物，口服后可通过使不平衡的胃肠道菌群正常化来预防抗生素相关性腹泻（AAD）。本系统综述的目的是评估益生菌在门诊预防AAD的益处和危害。对PubMed数据库进行了检索，共获得17项随机对照试验，共有3631名参与者纳入本综述。对主要结果AAD的发生率进行了荟萃分析。综合结果发现，与对照组的17.7%相比，益生菌组的AAD发生率为8.0% (RR = 0.49, 95% CI = 0.36 ~ 0.66; I2 = 58%)，菌种特异性结果与鼠李糖乳杆菌（L. rhamnosus GG）和博氏沙门氏菌（S. bourlardii）相似。然而，纳入研究的总体质量是中等的。对10个报告不良事件的试验的荟萃分析显示，干预组和对照组的不良事件发生率无统计学差异（RD为0.00,95% CI为- 0.02 ~ 0.02,2.363名受试者）。结果表明，益生菌的使用可能有助于预防门诊患者的AAD。此外，益生菌的使用似乎是安全的。
A common adverse effect of antibiotic use is diarrhea. Probiotics are living microorganisms, which, upon oral ingestion, may prevent antibiotic-associated diarrhea (AAD) by the normalization of an unbalanced gastrointestinal flora. The objective of this systematic review was to assess the benefits and harms of probiotics used for the prevention of AAD in an outpatient setting. A search of the PubMed database was conducted and yielded a total of 17 RCTs with 3631 participants to be included in the review. A meta-analysis was conducted for the primary outcome: the incidence of AAD. The pooled results found that AAD was present in 8.0% of the probiotic group compared to 17.7% in the control group (RR 0.49, 95% CI 0.36 to 0.66; I2 = 58%), and the species-specific results were similar regarding the probiotic strains L. rhamnosus GG and S. boulardii. However, the overall quality of the included studies was moderate. A meta-analysis of the ten trials reporting adverse events demonstrated no statistically significant differences in the incidence of adverse events between the intervention and control group (RD 0.00, 95% CI −0.02 to 0.02, 2.363 participants). The results suggests that probiotic use may be beneficial in the prevention of AAD among outpatients. Furthermore, the use of probiotics appears safe.
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