Abstract
In recent years, an increase in the prevalence of antibiotic-associated diarrhea (AAD) in children has been registered. In modern conditions, there are changes in the microbial spectrum of AAD pathogens and their sensitivity to antimicrobial drugs. This indicates the need for further research on the effectiveness and safety of the use of antidiarrheal drugs, in particular Saccharomyces boulardii (SB), in clinical practice. The objective: to analyze the clinical effectiveness and safety of the use of SB in the prevention of AAD manifestations in children. Materials and methods. The results of examination and treatment of 84 children aged 1 to 16 years with pneumonia (n=50) and acute bronchitis of bacterial etiology (n=34) were analyzed. Patients comparable in age, gender, etiology and clinical form of acute respiratory disease were divided into two research groups: I (main) group – 44 children who received SB for a course of 10–12 days in complex treatment (antibacterial and symptomatic therapy) and II (control) group – 40 patients who received only antibiotic therapy and did not take probiotic drugs. During the study, the condition of the digestive tract (appetite, presence of nausea and vomiting, frequency and severity of diarrhea), skin (dryness, drowsiness), nervous system (sleep disturbances, restlessness) was assessed. Results. At the beginning of the study there was no statistical difference between the frequency of pathological symptoms in the research groups. In the course of treatment, positive dynamics of clinical manifestations of respiratory tract lesions were observed in children in the groups. In the patients of the I group who received SB, on the 10th day all patients had formed stools, while in the II group, on the 10th day diarrhea was detected in 12 (30%) of 40 children (p<0.01). In the dynamics of treatment on the 10th–12th day, the decrease in the number of bifidobacteria (<1010) was found in 2 (6.7%) of 30 children of the I group and in 15 (60%) of the 25 children of the II group (р<0.01). A decrease in the number of lactobacilli (<107) was found in 1 (3.3%) of 30 children of group I and in 9 (36.0%) of 25 patients of group II (p<0.05). On the 10th–12th day, it was possible to achieve complete normalization of intestinal function in almost all children of the I group. There were no side effects during the use of the drug. Conclusions. The use of SB simultaneously with antibacterial therapy made it possible to reliably reduce flatulence and intestinal colic in 86.4–88.6% of children on the 5th day of complex treatment. In the main group the frequency and consistency of bowel movements quickly normalized. Such dynamics of clinical symptoms was not observed in the comparison group.
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