益生菌对化脓性扁桃腺炎治疗后发生抗生素相关性腹泻的影响

Effect of probiotic micro-organisms on antibiotic-associated diarrhoea in children with suppurative tonsillitis

摘要:

目的  观察益生菌对抗生素治疗化脓性扁桃体炎所继发抗生素相关性腹泻（AAD）是否有预防作用。方法  选择郑州市儿童医院门急诊使用广谱抗生素治疗537例化脓性扁桃体炎患儿。其中353例完成研究，将该353例化脓性扁桃体炎患儿随机分为干预组和对照组，干预组在抗生素治疗第1天加用益生菌，抗生素停止后继续应用3 d，观察组仅用抗生素，观察其出现AAD时间及数量。结果  两组患儿入组前后抗生素使用种类、途径及时间比较，差异无统计学意义，治疗随访结束时，干预组累计有22例发生AAD，发生率为11.17%，显著低于对照组的23.08%（χ2=8.993，P =0.003），两者比较差异有统计学意义（P <0.01），且ADD发生时间明显后移。危险度分析显示，相对于对照组，应用益生菌治疗后AAD发生风险降低58.1%。且腹泻发生时间除第1天外各组间比较差异有统计学意义（P <0.05）。在整个治疗观察期间无益生菌相关不良反应。结论  益生菌可以减低化脓性扁桃体炎抗生素治疗后AAD的发生，化脓性扁桃体炎患儿加用益生菌治疗是有益的。未发现其不良反应。

Abstract:

Objetive To evaluate the efficacy of live Clostridium butyricum and Bifidobacterium powder in preventing antibiotic-associated diarrhea (AAD) in children with suppurative tonsillitis. Methods In this randomized and placebo-controlled trial in Children`s Hospital of Zhengzhou City, 537 children with suppurative tonsillitis aged from 6 months to 15 years were enrolled. Among them 353 children completed the study and were randomly divided into two groups. Clostridium butyricum and Bifidobacterium powder was given daily to 197 children in the treatment group during the antibiotic treatment, while 156 children in the control group received antibiotics as a routine treatment for suppurative tonsillitis. The stool frequency and consistency were observed and recorded. Results Children in the two groups were similar in age distribution, sex and anti-biotics used. The incidence of AAD was higher in the control group (23.08%) than in the treatment group (11.17%, P < 0.01). And ADD occurred at a later time in the treatment group than in the control group. No related adverse reactions were found in the treatment group. Conclusions Live Clostridium butyricum and Bifidobacterium combined powder can effectively reduce the risk of AAD in children with suppurative tonsillitis without occurrence of related adverse reactions.