Antibiotic-Associated Syndrome in Clinical Practice

Abstract

Purpose of Research: Establishing clinical features of an antibiotic- associated diarrhea and extra-intestinal manifestations of an antibiotic- associated syndrome in children Patients and Methods: In 2017-2019 on the basis of GBUZ Infectious clinical hospital No. 2 DZ of Moscow a prospective clinical surveillance was carried out 200 patients aged 3 months to 13 years who were hospitalized with a diagnosis of acute pneumonia and received antibacterial therapy. All patients were evaluated for antibiotic-associated diarrhea (development of diarrhea, vomiting, dyspepsia, stomatitis) and manifestations of antibiotic-associated syndrome in children (condition of the skin and appendages of the skin, nervous system, development of inflammatory changes in the external genitals) within a month after antibiotic therapy. Comparative analysis of the effectiveness of probiotic prevention of antibiotic-associated syndrome was conducted in two groups: group 1 (23 children who received a drug containing Lactobacillus acidophilus, polysaccharide of kefir fungus in parallel with antibacterial therapy), group 2 (122 patients who received a medication containing Lactobacillus acidophilus, Bifidobacterium infantis, Enterococcus faecium). Results: 29% of patients had symptoms of antibiotic-associated syndrome. AAD symptoms were diagnosed in 13% of patients. Abdominal pain (32.8%), dyspepsia symptoms (22.4%), bad breath (17.2%), flatulence (17.2%), stomatitis (10.3%), and constipation (1.7%) associated with antibiotic therapy were found among the manifestations of antibiotic-associated gastrointestinal syndrome. Dry skin was observed in 15.5% of patients, diaper rash-3.4%, brittle nails-15.5%, peeling of the skin-3.4% of patients, increased irritability in 17.2%, inflammatory changes in the external genitals-in 1.7% of patients. Comparative analysis of various probiotic prophylaxis of AAD showed that 1 group patients were significantly more likely to have stomatitis (p<0.01) and dry skin (p<0.05) than patients in group 2. Summary: New term “ antibiotic-associated syndrome» implies the development of a wider range of clinical manifestations associated with the use of antibacterial agents than the development of antibiotic-associated diarrhea. The use of probiotic prophylaxis with a medication containing Lactobacillus acidophilus, Bifidobacterium infantis, Enterococcus faecium demonstrates high efficiency compared to the comparison group.