Saccharomyces boulardii and antibiotic‐associated diarrhoea in children

Abstract

Sirs, We read with great interest the recent paper by Kotowska et al.1 about Saccharomyces boulardii (S. boulardii) in the prevention of antibiotic-associated diarrhoea (AAD) in children. The study adds important information about probiotic prophylaxis for AAD in children. Authors reported that treatment with S. boulardii had been given twice daily (500 mg/day) for the duration of the antibiotic treatment in 269 children, and it was concluded that S. boulardii had reduced the overall risk of AAD from 17.3% to 3.4% when compared with the control group.1 A randomized, controlled study concerning the efficacy of S. boulardii as an adjunct to sulbactam-ampicillin (SAM) or azithromycin for prophylaxis of AAD in 466 children, was conducted by our clinic2 but not discussed by Kotowska et al. We showed that S. boulardii taken once daily (250 mg/day) significantly decreased the AAD rate from 25.6% to 5.7% in children receiving SAM. The highest rate of AAD was in children treated with SAM and who were below six years of age, so we suggested the use of S. boulardii at the dose of 250 mg/day as an adjunct to SAM – especially at this age group for prevention of AAD.