Probiotics do not improve the benefits of a hospital treatment protocol for acute diarrhea in the breastfed child.

Authors

  • Sergio Santana Porbén Médico, Especialista de Segundo Grado en Bioquímica Clínica. Máster en Nutrición en Salud Pública. Profesor Asistente. Hospital Pediátrico Docente “Juan Manuel Márquez”. La Habana.
  • Eduardo Piñeiro Fernández Médico, Especialista de Primer Grado en Pediatría. Máster en Atención integral al niño. Profesor Auxiliar. Hospital Pediátrico Docente “Juan Manuel Márquez”. La Habana.
  • Rafael Jiménez García Médico, Especialista de Segundo Grado en Pediatría. Profesor Auxiliar. Investigador Auxiliar. Máster en Atención integral al niño. Hospital Pediátrico Docente “Juan Manuel Márquez”. La Habana.
  • Stefanie Marcela Ruiz Fallas Médico, Especialista de Primer Grado en Pediatría. Hospital Pediátrico Docente “Juan Manuel Márquez”. La Habana.

DOI:

https://doi.org/10.19230/jonnpr.2016.1.6.1081

Keywords:

Probiotics, Breastfed child, Acute diarrhea, Inflammation, Iron

Abstract

Rationale: Probiotics have been used in the treatment of acute diarrhea occurring in pediatric ages with mixed results.

Objective: To assess the impact of a probiotic (CFU per capsule: Lactobacillus rhamnosus G: 2 x 109, Lactobacillus cassei: 1 x 109, Bifidobacterium brevis: 2 x 109) upon the features and duration of acute diarrhea in breastfed children.

Study location: Digestive Diseases and Nutrition Service, “Juan Manuel Márquez” Pediatric Teaching Hospital (Marianao, Havana
City, Cuba).

Study design: Open, quasi-experimental trial. Thirty children with ages < 2 years consecutively assisted in the service due to acute diarrhea (On admission: 5.7 ± 3.7 stools.day-1) received 1 probiotic capsule daily during 10 days. Impact of probiotic was measured from changes in body weight, hematological variables, and the features and days of duration of diarrheas. Effectiveness of administered probiotic was compared with that of the actions prescribed in institutional protocols.

Results: Probiotics were not better than current therapeutical protocol for improving stool pattern of the breatsfed child: Reduction in the number of daily stools: Non-Treated: 100.0% vs. Treated: 90.0% (p > 0.05); Improvement of the features of stools: Non-Treated: 93.3% vs. Treated: 96.1% (p > 0.05). Use of probiotics produced an increase of Hemoglobin (

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References

Szajewska H, Guarino A, Hojsak I, Indrio F, Kolacek S, Shamir R; et al. Use of probiotics for management of

acute gastroenteritis: A position paper by the ESPGHAN Working Group for Probiotics and Prebiotics. J

Pediatr Gastroenterol Nutr 2014;58:531-9.

Huang JS, Bousvaros A, Lee JW, Diaz A, Davidson EJ. Efficacy of probiotic use in acute diarrhea in children:

A meta-analysis. Dig Dis Sci 2002;47:2625-34.

Cremonini F, Di Caro S, Nista EC, Bartolozzi F, Capelli G, Gasbarrini G, Gasbarrini A. Meta-analysis: The

effect of probiotic administration on antibiotic-associated diarrhoea. Aliment Pharmacol Ther 2002;16:1461-7.

Rohde CL, Bartolini V, Jones N. The use of probiotics in the prevention and treatment of antibiotic-associated

diarrhea with special interest in Clostridium difficile-associated diarrhea. Nutr Clin Pract 2009;24:33-40.

Alisi A, Bedogni G, Baviera G, Giorgio V, Porro E, Paris C; et al. Randomised clinical trial: The beneficial

effects of VSL# 3 in obese children with non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2014;39:1276-

Foolad N, Armstrong AW. Prebiotics and probiotics: The prevention and reduction in severity of atopic

dermatitis in children. Beneficial Microbes 2014; 5:151-60.

Tsai YT, Cheng PC, Pan TM. Anti-obesity effects of gut microbiota are associated with lactic acid bacteria.

Applied Microbiol Biotechnol 2014;98: 1-10.

Di Gioia D, Aloisio I, Mazzola G, Biavati B. Bifidobacteria: Their impact on gut microbiota composition and

their applications as probiotics in infants. Appl Microbiol Biotechnol 2014;98: 563-77.

Ouwehand AC, Dong-Lian C, Weijian X, Stewart M, Ni J, Stewart T, Miller LE. Probiotics reduce symptoms of

antibiotic use in a hospital setting: A randomized dose response study. Vaccine 2014;32:458-63.

Pattani R, Palda VA, Hwang SW, Shah PS. Probiotics for the prevention of antibiotic-associated diarrhea and

Clostridium difficile infection among hospitalized patients: Systematic review and meta-analysis. Open

Medicine 2013; 7:56-67.

Szajewska H, Ruszczy

acidophilus LB to treat acute gastroenteritis in children. Acta Paediatrica, 2014;103:249-55.

Brouwer ML, Wolt-Plompen SAA, Dubois AEJ, van der Heide S, Jansen DF, Hoijer MA; et al. No effects of

probiotics on atopic dermatitis in infancy: A randomized placebo-controlled trial. Clin Exp Allergy 2006;

:899-906.

García Pastrana T, García Arnao O, Valerino Meriño I, Farramola Bello LA. Aspectos generales sobre el uso

de antimicrobianos en Pediatría. Rev Cubana Investigaciones Biomédicas 2013;32:21-8.

Santana Porbén S, Barreto Penié J, González Pérez TL. Capítulo 4: Mediciones antropométricas. En:

Programa de intervención alimentario, nutrimental y metabólico para hospitales pediátricos. Editorial

PalcoGraf. La Habana: 2000.

Grimshaw J, Campbell M, Eccles M, Steen N. Experimental and quasi-experimental designs for evaluating

guideline implementation strategies. Family Practice 2000;17:S11–S18.

Hollis S, Campbell F. What is meant by intention to treat analysis? Survey of published randomised controlled

trials. BMJ 1999;319:670-47.

López San Román A, Bermejo F, Carrera E, Pérez Abad M, Boixeda D. Adhesión al tratamiento en la

enfermedad inflamatoria intestinal. Rev Esp Enferm Dig 2005; 97: 249-57.

Santana Porbén S, Barreto Penié J, González Pérez TL. Capítulo 5: Necesidades energéticas y

nutrimentales. En: Programa de intervención alimentario, nutrimental y metabólico para hospitales pediátricos.

Editorial PalcoGraf. La Habana: 2000.

Anónimo. PNO 2.016.98: Encuestas dietéticas. Manual de Procedimientos. Grupo de Apoyo Nutricional.

Hospital Clínico-quirúrgico “Hermanos Ameijeiras”. La Habana: 2012. Tercera Edición.

Jiménez R, Curbelo JL, Peñalver R. Relación del tipo de alimentación con algunas variables del crecimiento,

estado nutricional y morbilidad del lactante. Colombia Médica 2005;36(4 Supl 3):19-25.

Marteau P, Seksik P, Jian R. Probiotics and intestinal health effects: A clinical perspective. Br J Nutr

;88(Suppl 1):S51-S57.

Santana Porbén S, Martínez Canalejo H. Manual de Procedimientos Bioestadísticos. Segunda Edición. EAE

Editorial Académica Española. ISBN-13:9783659059629. ISBN-10: 3659059625. Madrid: 2012.

Jiménez García R, Sagaró González E, Peñalver Valdés R. Methodological algorithm for planning nutritional

treatment for hospitalized children in a pediatric nutrition unit with limited resources. Proceedings of the

Annual Meeting and Postgraduate Course. NASPGHAN. Utah: 2005. pp 35.

Oelschlaeger TA. Mechanisms of probiotic actions– A review. Int J Med Microbiol 2010; 300:57-62.

De Preter V, Hamer HM, Windey K, Verbeke K. The impact of pre-and/or probiotics on human colonic

metabolism: Does it affect human health? Mol Nutr Food Res 2011;55:46-57.

Bezkorovainy A, Kot E. Interaction of bifidobacteria with ferric iron. Int Dairy J 1998;8:507-12.

Sazawal S, Dhingra U, Hiremath G, Sarkar A, Dhingra P, Dutta A; et al. Effects of Bifidobacterium lactis

HN019 and prebiotic oligosaccharide added to milk on iron status, anemia, and growth among children 1 to 4

years old. J Pediatr Gastroenterol Nutr 2010; 51:341-6.

Walker WA. Mechanisms of action of probiotics. Clin Infect Dis 2008; 46(Suppl 2):S87-S91.

Ganz T, Nemeth E. Iron sequestration and anemia of inflammation. Seminars Hematol 2009;46:387-93.

Nemeth E, Rivera S, Gabayan V, Keller C, Taudorf S, Pedersen BK, Ganz T. IL-6 mediates hypoferremia of

inflammation by inducing the synthesis of the iron regulatory hormone hepcidin. J Clin Invest 2004;113:1271-

Ganz T. Hepcidin, a key regulator of iron metabolism and mediator of anemia of inflammation. Blood

;102:783-8.32.

Andreasen AS, Larsen N, Pedersen-Skovsgaard T, Berg RM, Møller K, Svendsen KD; et al. Effects of

Lactobacillus acidophilus NCFM on insulin sensitivity and the systemic inflammatory response in human

subjects. Brit J Nutr 2010;104:1831-8.

Published

2016-09-09