Антибиотикоассоциированная диарея: бояться или действовать?

Плоскирева А.А., Голден Л.Б. Антибиотикоассоциированная диарея: бояться или действовать? Педиатрия (Прил. к журн. Consilium Medicum). 2017; 4: 67–70.

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Ploskireva A.A., Golden L.B. Antibiotic-associated diarrhea: afraid or act? Pediatrics (Suppl. Consilium Medicum). 2017; 4: 67–70.

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Аннотация

В статье представлены современные данные по патогенезу и клиническим особенностям антибиотикоассоциированной диареи (ААД) у детей – одного из серьезных нежелательных явлений при проведении антибактериальной терапии. Показана роль в профилактике и терапии ААД пробиотических лекарственных средств, которые при лечении больных, нуждающихся в антибактериальной терапии, рекомендовано назначать как можно в более ранние сроки – оптимально с начала применения антибиотиков. Выбор пробиотического лекарственного средства в данном случае должен основываться на знаниях о свойствах штаммов, входящих в состав пробиотического препарата. К числу наиболее изученных пробиотических штаммов, доказавших свою эффективность в профилактике и терапии ААД, относятся Bifidobacterium animalis, подвид lactis (BB-12). В статье показаны результаты проведенных ранее исследований как в нашей стране, так и за рубежом, наглядно демонстрирующие эффективность данного микроорганизма.

Ключевые слова: антибиотикоассоциированная диарея, пробиотики, Bifidobacterium animalis lactis (BB-12).

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The article presents up-to-date data on the pathogenesis and clinical features of antibiotic-associated diarrhea (AAD) in children – one of the serious adverse events in antibiotic therapy. The role of probiotic drugs in the prevention and therapy of AMA is shown. It is recommended to prescribe as soon as possible in the treatment of patients who need antibacterial therapy – it is optimal from the beginning of antibiotic use. The choice of the probiotic drug in this case should be based on knowledge of the properties of the strains that make up the probiotic preparation. Among the most studied probiotic strains that have proven effective in the prevention and therapy of AMA include Bifidobacterium animalis, subspecies lactis (BB-12). The article shows the results of earlier studies both in our country and abroad, which clearly demonstrate the effectiveness of this microorganism.

Key words: antibiotic-associated diarrhea, probiotics, Bifidobacterium animalis lactis (BB-12).

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Список литературы

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21. Hawrelak JA, Whitten DL, Myers SP. Is Lactobacillus rhamnosus GG effective in preventing the onset of antibiotic-associated diarrhoea: a systematic review. Digestion 2005; 72: 51–6.
22. Bhalla A. Randomized placebo-controlled, double blind, multicentric trial on efficacy and safety of providac techsules (lactobacillus acidophilus LA-5 and bifidobacterium BB-12) for prevention of antibiotic-associated diarrhea in Indian patients [in: Abstracts: 40th Annual Meeting of the American college of clinical pharmacology; September 11–13, 2011; Chicago, IL]. J Clin Pharmacol 2011; 51 (9): 1327.
23. Chatterjee S, Kar P, Das T et al. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated diarrhoea. J Assoc Physicians India 2013; 61 (10): 708–12.
24. Каннер Е.В., Горелов А.В., Крутихина С.Б. Антибиотикоассоциированная диарея у детей: современный взгляд на проблему. Мед. совет. 2017; 1: 226–30. / Kanner E.V., Gorelov A.V., Krutihina S.B.,. Antibiotikoassociirovannaja diareja u detej: sovremennyj vzgljad na problemu. Med. sovet. 2017; 1: 226–30. [in Russian]
25. Akanbi O et al. Antibiotic-associated haemorrhagic colitis: not always Clostridium difficile. BMJ Case Rep 2017. PII: bcr-2017-219915. DOI: 10.1136/bcr-2017-219915.
26. Vanderhoof JA, Whitney DB, Antonson DL et al. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr 1999; 135: 564–8.
27. Turck D, Bernet JP, Marx J et al. Incidence and risk factors for of oral antibiotic-associated diarrhea in an outpatient pediatric population. J Pediatr Gastroenterol Nutr 2003; 37: 22–6.
28. Probiotics and prebiotics. Practice Guideline World Gastroenterology Organization, 2011. http://www.worldgastroenterology.org/UserFiles/file/guidelines/probiotics-english-2011.pdf
29. Sheu B-S, Wu J-J, Lo C-Y et al. Impact of supplement with Lactobacillus- and Bifidobacteriumcontaining on triple therapy for Helicobacter pylori Eradication. Aliment Pharmacol Ther 2002; 16: 1669–75.
30. Xu HB et al. Meta-analysis of the effects of Bifidobacterium preparations for the prevention and treatment of pediatric antibiotic-associated diarrhea in China. Complement Ther Med 2017; 33: 105–13. DOI: 10.1016/j.ctim.2017.07.001.

________________________________________________

1. Gorelov A.V., Usenko D.V. Sovremennye podkhody k profilaktike antibiotikoassotsiirovannoi diarei u detei. Pediatrics (Suppl. Consilium Medicum). 2005; 7 (2). [in Russian]
2. McFarland L.V. Epidemiology, risk factors and treatments for antibiotic-associated diarrhea. Dig Dis 1998; 16: 292–307.
3. Wiström J, Norrby SR, Myhre EB et al. Frequency of antibiotic-associated diarrhea in 2462 antibiotic-treated hospitalized patients: a prospective study. J Antimicrob Chemother 2001; 47: 43–50.
4. Elstner CL, Lindsay AN, Book LS, Matsen JM. Lack of relationship of Clostridium difficile to antibiotic-associated diarrhoea in children. Pediatr Inf Dis 1983; 2: 364–6.
5. Turck D, Bernet JP, Marx J et al. Incidence and risk factors of oral antibiotic-associated diarrhea in an outpatient pediatric population. J Pediatr Gastroenterol Nutr 2003; 37: 22–6.
6. Kotowska M, Albrecht P, Szajewska H. Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: a randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther 2005; 21: 583–90.
7. Lobzin Iu.V., Zakharenko S.M., Ivanov G.A. Sovremennye predstavleniia ob infektsii Clostridium difficile. Klin. mikrobiologiia i antimikrobnaia khimioterapiia. 2002; 3 (4): 200–32. [in Russian]
8. Ploskireva A.A., Gorelov A.V. Sistemnyi podkhod k otsenke mikrobiotsenoza zheludochno-kishechnogo trakta pri ostrykh kishechnykh infektsiiakh u detei. Sovr. problemy nauki i obrazovaniia. 2015; 5. http://www.science-education.ru/ru/article/view?id=22040 [in Russian]
9. Beaugerie L, Petit JC. Microbial-gut interactions in health and disease. Antibiotic-associated diarrhea. Best Pract Res Clin Gastroenterol 2004; 18: 337–52.
10. Clausen MR, Bonnen H, Tvede M, Mortensen PB. Colonic fermentation to short-chain fatty acids is decreased in antibiotic-associated diarrhea. Gastroenterology 1991; 101: 1497–504.
11. Asha NJ, Tompkins D, Wlilcox MH. Comparative analysis of prevalence, risk factors, and molecular epidemiology of antibiotic-associated diarrhea due to Clostridium difficile, Clostridium perfringens and Staphylococcus aureus. J Clin Microbiol 2006; 44: 2785–91.
12. Hogenauer C, Langner C, Beubler E. Klebsiella oxytoca as a causative organism of antibiotic-associated hemorrhagic colitis. N Engl J Med 2006; 355: 2418–26.
13. Hogenauer C, Hammer HF, Krejs GJ, Reisinger EC. Mechanisms and management of antibiotic-associated diarrhea. Clin Infect Dis 1998; 27: 702–10.
14. Thomas MR, Litin SC, Osmon DR et al. Lack of effect of Lactobacillus GG on antibiotic-associated diarrhea: a randomized, placebo-controlled trial. Mayo Clin Proc 2001; 76: 883–9.
15. Ivashkin V.T., Sheptulin A.A. Sindrom diarei. M.: GEOTAR-Meditsina, 2000. [in Russian]
16. Floch MH. Recommendations for Probiotic Use in Humans – 2014 Update. Pharmaceuticals (Basel) 2014; 7 (10): 999–1007.
17. McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol 2006; 101: 812–22.
18. D’Souza AL, Rajkumar C, Cooke J, Bulpitt CJ. Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis. Br Med J 2002; 324: 1361–4.
19. Cremonini F, Di Caro S, Nista EC et al. Meta-analysis: the effect of probiotic administration on antibiotic-associated diarrhoea. Aliment Pharmacol Ther 2002; 16: 1461–7.
20. Szajewska H, Mrukowicz J. Meta-analysis: non-pathogenic yeast Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea. Aliment Pharmacol Ther 2005; 22: 365–72.
21. Hawrelak JA, Whitten DL, Myers SP. Is Lactobacillus rhamnosus GG effective in preventing the onset of antibiotic-associated diarrhoea: a systematic review. Digestion 2005; 72: 51–6.
22. Bhalla A. Randomized placebo-controlled, double blind, multicentric trial on efficacy and safety of providac techsules (lactobacillus acidophilus LA-5 and bifidobacterium BB-12) for prevention of antibiotic-associated diarrhea in Indian patients [in: Abstracts: 40th Annual Meeting of the American college of clinical pharmacology; September 11–13, 2011; Chicago, IL]. J Clin Pharmacol 2011; 51 (9): 1327.
23. Chatterjee S, Kar P, Das T et al. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated diarrhoea. J Assoc Physicians India 2013; 61 (10): 708–12.
24. Kanner E.V., Gorelov A.V., Krutihina S.B.,. Antibiotikoassociirovannaja diareja u detej: sovremennyj vzgljad na problemu. Med. sovet. 2017; 1: 226–30. [in Russian]
25. Akanbi O et al. Antibiotic-associated haemorrhagic colitis: not always Clostridium difficile. BMJ Case Rep 2017. PII: bcr-2017-219915. DOI: 10.1136/bcr-2017-219915.
26. Vanderhoof JA, Whitney DB, Antonson DL et al. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr 1999; 135: 564–8.
27. Turck D, Bernet JP, Marx J et al. Incidence and risk factors for of oral antibiotic-associated diarrhea in an outpatient pediatric population. J Pediatr Gastroenterol Nutr 2003; 37: 22–6.
28. Probiotics and prebiotics. Practice Guideline World Gastroenterology Organization, 2011. http://www.worldgastroenterology.org/UserFiles/file/guidelines/probiotics-english-2011.pdf
29. Sheu B-S, Wu J-J, Lo C-Y et al. Impact of supplement with Lactobacillus- and Bifidobacteriumcontaining on triple therapy for Helicobacter pylori Eradication. Aliment Pharmacol Ther 2002; 16: 1669–75.
30. Xu HB et al. Meta-analysis of the effects of Bifidobacterium preparations for the prevention and treatment of pediatric antibiotic-associated diarrhea in China. Complement Ther Med 2017; 33: 105–13. DOI: 10.1016/j.ctim.2017.07.001.

Авторы

А.А.Плоскирева*1, Л.Б.Голден2

1 ФБУН «Центральный НИИ эпидемиологии» Роспотребнадзора. 111123, Россия, Москва, ул. Новогиреевская, д. 3а;
2 ГБУЗ «Инфекционная клиническая больница №2» Департамента здравоохранения г. Москвы. 105275, Россия, Москва, 8-я ул. Соколиной горы, д. 15
*antoninna@mail.ru

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A.A.Ploskireva*1, L.B.Golden2

1 Central Research Institute of Epidemiology of The Federal Service on Customers. 111123, Russian Federation, Moscow, ul. Novogireevskaia, d. 3a;
2 Infectious Diseases hospital №2 of the Department of Health of Moscow. 105275, Russian Federation, Moscow, 8-ia ul. Sokolinoi gory, d. 15
*antoninna@mail.ru

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