Development of pathogenetically justified approaches to therapy of young children with acute respiratory infections requiring antibacterial drugs

Abstract

The purpose of the study: to evaluate the protective properties of a multi-strain probiotic in the development of gastrointestinal disorders with impaired microbiota during antibiotic therapy (ABT) for 1 to 3 years old children with acute respiratory infection (ARI). Objectives of research: to evaluate the incidence of development and severity of gastrointestinal disorders, as well as changes in the dynamics of intestinal microbiota using 16S rRNA gene sequencing in 1 to 3 years old children with ARI and receiving ABT, depending on the addition of a multi-strain probiotic to the treatment regimen. Materials and methods: the study involved 148 children from 1 to 7 years old both girls and boys (54 children were 1 to 3 y.o. and 65 were 3 to 7 y.o.), hospitalized within first 3 days of URTI symptoms (acute upper respiratory tract infection – URTI) and 29 healthy children from outpatient department as a healthy control. Present article covers data and outcomes of younger age group – 54 children 1 to 3 years old, hospitalized within first 3 days of illness and 10 healthy children of the same age range. The main group included 27 children who received ABT + multi-strain probiotic Bac-Set® Baby for the entire period of ABT and extra 14 days after its discontinuation; the comparison group included 27 children who received only ABT. The frequency of bowel movements was assessed, feces were evaluated accordingly to Bristol scale upon admission to the hospital, befor e discharge from the hospital (in 7 ± 2 days), and in 21 ± 2 days from the beginning of ABT. Results. The frequency of bowel movements after 7 ± 2 days and 21 ± 2 days from the start of therapy was significantly higher in the comparison group than in the main group (81.5% and 26% versus 7.4% and 7.4%, respectively). The stool rate accordingly to Bristol scale in the comparison group changed up to moderate diarrhea, which was not registered in the main group. In both groups, an increase in alpha-diversity of microbiota was observed within 2-week period after discontinuation of antibiotic therapy. During the study, adverse reactions of multi-strain probiotic were not found. Conclusions. The results allow to suggest that the use of Bac-Set® Baby multistrain probiotic helps to maintain the stability of the microbiome during antibiotic therapy and in the recovery period after it. The use of Bac-Set® Baby with antibacterial therapy has a protective effect on gastrointestinal upsets incidence rate and reduces the negative impact on microbiome.