Indian Academy of Pediatrics Consensus Guidelines for Probiotic Use in Childhood Diarrhea

Yachha, Surender Kumar; Sarma, Moinak Sen; Mohan, Neelam; Wadhwa, Nishant; Vr, Nagendra Kumar; Srinivasan, Ramesh; Shah, Dheeraj; Soans, Santosh; Yewale, Vijay; Basavaraja, G V; Parekh, Bakul Jayant

doi:10.1007/s13312-022-2557-7

Cited by 7 publications

(4 citation statements)

References 49 publications

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Section: Evidence-based Impact Of Antibiotic Administration On Gut Mi...mentioning

confidence: 99%

“…78 Antibiotics, such as cephalosporins, aminopenicillins without/with clavulanate, clindamycin, and anti-anaerobic antimicrobial agents, whether used orally or intravenously, pose a high risk of causing AAD. 79 C difficile-associated diarrhea. In some cases, AAD can be caused by an overgrowth of C diffi cile, referred to as CDAD.…”

Section: Children With Recurrent Infectionsmentioning

confidence: 99%

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Current understanding of antibiotic-associated dysbiosis and approaches for its management

Kesavelu

Jog

2023

Therapeutic Advances in Infection

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Increased exposure to antibiotics during early childhood increases the risk of antibiotic-associated dysbiosis, which is associated with reduced diversity of gut microbial species and abundance of certain taxa, disruption of host immunity, and the emergence of antibiotic-resistant microbes. The disruption of gut microbiota and host immunity in early life is linked to the development of immune-related and metabolic disorders later in life. Antibiotic administration in populations predisposed to gut microbiota dysbiosis, such as newborns, obese children, and children with allergic rhinitis and recurrent infections; changes microbial composition and diversity; exacerbating dysbiosis and resulting in negative health outcomes. Antibiotic-associated diarrhea (AAD), Clostridiodes difficile-associated diarrhea (CDAD), and Helicobacter pylori infection are all short-term consequences of antibiotic treatment that persist from a few weeks to months. Changes in gut microbiota, which persist even 2 years after antibiotic exposure, and the development of obesity, allergies, and asthma are among the long-term consequences. Probiotic bacteria and dietary supplements can potentially prevent or reverse antibiotic-associated gut microbiota dysbiosis. Probiotics have been demonstrated in clinical studies to help prevent AAD and, to a lesser extent, CDAD, as well as to improve H pylori eradication rates. In the Indian setting, probiotics ( Saccharomyces boulardii and Bacillus clausii) have been shown to reduce the duration and frequency of acute diarrhea in children. Antibiotics may exaggerate the consequences of gut microbiota dysbiosis in vulnerable populations already affected by the condition. Therefore, prudent use of antibiotics among neonates and young children is critical to prevent the detrimental effects on gut health.

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Section: Evidence-based Impact Of Antibiotic Administration On Gut Mi...mentioning

confidence: 99%

Section: Children With Recurrent Infectionsmentioning

confidence: 99%

Current understanding of antibiotic-associated dysbiosis and approaches for its management

Kesavelu

Jog

2023

Therapeutic Advances in Infection

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“…The probiotic mechanisms of these beneficial yeasts have been well recognized, particularly for S. boulardii, which is conventionally used to prevent and treat diarrhea, mainly antibiotic-associated, in adults and children [70]. The protective action of S. boulardii against bacterial infections results from the complementary effect of several mechanisms, mainly [71]:…”

Section: Saccharomycetesmentioning

confidence: 99%

Use of Probiotics for Oral Candidiasis: State of the Art and Perspective. A Further Step Toward Personalized Medicine?

Contaldo¹

2023

Front. Biosci. (Elite Ed)

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Oral candidiasis is an opportunistic infection conventionally treated with antifungal drugs. However, the increasing number of fungal infections, parallel to the rising conditions sustained by non-albicans species, pose critical issues related to escalating drug resistances differently acquired by different species. Meanwhile, the knowledge of the interplay between oral microbiota and its host suggests alternative antifungal therapies based on the administration of probiotics. Probiotics are live microorganisms beneficial to the host, and literature reports consistent evidence for their use to treat gut diseases. The present work aimed to overview the primary mechanisms through which probiotics act against Candida species and the current status of knowledge on their use in clinical practice, particularly concerning oral candidiasis.

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“…4 The latest guidelines by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the Indian Academy of Pediatrics (IAP), published separately in 2022, positively recommend Lactobacillus rhamnosus GG and Saccharomyces boulardii, which are also two of the most commonly prescribed probiotics in pediatric population. 5,6 Despite the recommendations, there is insufficient head-on comparative data on the efficacy of these two probiotics. In order to further reduce the ambiguity around choosing the probiotic strain in the Indian population, this study aimed to compare the efficacy of Lactobacillus rhamnosus GG and Saccharomyces boulardii as an adjunct treatment for acute diarrhea in children aged 6-36 months.…”

Section: Introductionmentioning

confidence: 99%

Comparative, randomized-controlled trial on efficacy and safety of Lactobacillus rhamnosus GG and Saccharomyces boulardii in treatment of acute diarrhea in Indian children (COMPARE-GG trial)

Biswas

Bal

2023

Int J Clin Trials

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Background: Probiotics are routinely prescribed to boost gut health and reduce severity of diarrhea. This study aimed to compare the efficacy and safety of Lactobacillus rhamnosus GG (LrGG) and Saccharomyces boulardii as an adjunct treatment for acute diarrhea in Indian children aged 6–36 months. Methods: In this single-center, open label, comparative, randomized controlled study, children were randomized into three groups (n=35, each) and provided either low osmolarity oral rehydration solution (ORS) and zinc (20 mg/day) alone or ORS+Zinc supplemented with one of the two probiotic preparations, LrGG ATCC 53103 or S. boulardii CNCM 1-745. Children were monitored every 8 hours after admission and the duration of diarrhea and hospital stay, and stool frequency were evaluated. Results: Of the total 105 children enrolled in the study, majority were aged between 13–24 months (40%). LrGG significantly reduced the mean duration of diarrhea by nearly 19 hours, when compared to the control group (p=0.003), while reduction by S. boulardii was not significant. The mean hospital stay duration for control group was about 6 days, which was significantly reduced (p=0.0001) by nearly 23 hours by LrGG, and non-significantly by S. boulardii. On day 2, LrGG significantly reduced stool frequency by 32.31%, as compared to 27.44% reduction in control group. S. boulardii reduced stool frequency by 31.76%, which was not statistically significant compared to that in control group. Conclusions: LrGG showed statistically significant reduction in duration of diarrhea and hospital stay, when compared against the group receiving ORS+zinc either alone or with S. boulardii.

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Indian Academy of Pediatrics Consensus Guidelines for Probiotic Use in Childhood Diarrhea

Cited by 7 publications

References 49 publications

Current understanding of antibiotic-associated dysbiosis and approaches for its management

Current understanding of antibiotic-associated dysbiosis and approaches for its management

Use of Probiotics for Oral Candidiasis: State of the Art and Perspective. A Further Step Toward Personalized Medicine?

Comparative, randomized-controlled trial on efficacy and safety of Lactobacillus rhamnosus GG and Saccharomyces boulardii in treatment of acute diarrhea in Indian children (COMPARE-GG trial)

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