Probiotic <i>Lactobacillus casei Shirota</i> improves efficacy of amoxicillin-sulbactam against childhood fast breathing pneumonia in a randomized placebo-controlled double blind clinical study

Abstract

The aim of the present study was to investigate the efficacy of oral administration of probiotic Lactobacillus casei Shirota and amoxicillin-sulbactam in treating childhood fast breathing pneumonia. 518 children diagnosed of fast breathing pneumonia were enrolled and randomly assigned to be administered either amoxicillin-sulbactam + Lactobacillus casei Shirota or amoxicillin-sulbactam + placebo. Primary outcome was defined as treatment failure before day 3, and secondary outcome was defined as treatment failure during follow-ups on day 6 and 12. Serum levels of tumor necrosis factor-α and interferon-γ were also examined at the end of day 3. Treatment failure rate before day 3 was significantly reduced in amoxicillin-sulbactam + Lactobacillus casei Shirota group compared to amoxicillin-sulbactam + placebo group. Serum levels of tumor necrosis factor-α and interferon-γ were both significantly reduced in amoxicillin-sulbactam + placebo group on day 3. On day 6 and 12, although treatment failure rates were higher than on day 3 in both groups, it was still significantly reduced in amoxicillin-sulbactam + Lactobacillus casei Shirota group. No severe adverse effects were observed in either treatment group. In conclusion, Probiotic Lactobacillus casei Shirota, in combination with amoxicillin-sulbactam, is more effective in treating childhood fast breathing pneumonia, which supports the potential clinical application of Lactobacillus casei Shirota as a safe supplement to amoxicillin-sulbactam therapy against childhood fast breathing pneumonia.

Therapeutic enhancement of antibiotics using probiotics: a review

“…Also, L. shirota has evidence of safe consumption with numerous health benefits and its immune modulating properties thus improving the efficiency of amoxicillin sulbactam in treatment. In conclusion L. shirota can be used as an adjuvant for further treatment (Li et al 2018). The result showed a reduction in the biotoxicity of CFX and CPR, when looking into their degradation products.…”

Role of Probiotics in Neonates with Hyperbilirubinemia Receiving Phototherapy

“…12 Though phototherapy is in practice for more than 50 years, its complications predominantly hypocalcemia put a limit to its prolonged use 12,13 . Therefore measures which can reduce the length of phototherapy are hot focus of research [4][5][6][7] . Recent studies claimed that probiotics supplementation of jaundiced neonates significantly reduced the mean duration of phototherapy and advocated its preferred use in future practice 6,7 .…”

“…During the past decade, probiotics has gained much popularity 3 and their clinical use has seen a significant rise where there are reports of their benefit in patients with acute and chronic diarrhea 4 and pneumonia. 5 There has been studies investigating their role in the clinical management of neonates with hyperbilirubinemia 6,7 but with controversial results. [8][9][10] Torkaman et al 8 (2017) reported that mean duration of phototherapy was significantly shorter in neonates receiving probiotics in addition to phototherapy as compared to neonates receiving phototherapy alone (3.13±0.70 vs. 3.55±0.74 days; p-value<0.001) in Iran.…”

Potential Effects Immunomodulators on Probiotics in COVID-19 Preventing Infection in the Future. A Narrative Review

“…25,26 Antiinflammatory activity in the lungs plays a role in decreasing lung inflammation such as decreasing the levels of proinflammatory cytokines and C-reactive protein (CRP). 27 Probiotic bacteria produce metabolites in the form of short-chain fatty acids (SCFA) consisting of acetate, propionate, and butyrate which are widely present in the colon epithelium. Parts of the butyrate are used as energy by the colonocytes while the rest of the other SCFA are absorbed into the portal circulation through the intestine.…”