Влияние пробиотиков на продолжительность осмо-секреторной диареи при острых кишечных инфекциях у детей

Nowadays acute gastroenteritis retains the leading infectious disorder in children, has viral etiology and osmosecretory type of diarrhea in the most cases. Probiotics are considered highly effective medicines as part of the complex gastroenteritis therapy in children. The choice of the probiotics is limited by strains with proven efficacy and complicated by a large range of commercially available probiotics. The aim of the comparative post-registration prospective study was to evaluate the efficacy and safety the probiotic drug Adiarin Probio for treatment of osmosecretory diarrhea inpatient children. The study included 60 hospitalized children aged 6 months to 7 years. Results: the efficacy and safety as well as high adherence to the Adiarin Probio in children with osmosecretory diarrhea were confirmed.В современных условиях острые кишечные инфекции (ОКИ) сохраняют ведущие позиции в структуре инфекционной патологии детского возраста с преобладанием вирусной этиологии заболевания и осмо-секреторным типом диареи. Пробиотики в составе комплексной терапии гастроэнтеритов у детей считаются высокоэффективными средствами. Выбор препарата ограничивается штаммами с доказанной эффективностью и осложняется большим спектром пробиотических средств на фармацевтическом рынке. Целью проведенного сравнительного пострегистрационного проспективного исследования была оценка эффективности и безопасности применения пробиотического препарата Адиарин Пробио при осмо-секреторных диареях у детей в условиях стационара. В исследование включено 60 госпитализированных детей в возрасте от 6 мес. до 7 лет. В результате подтверждена эффективность и безопасность Адиарин Пробио при осмо-секреторных диареях у детей, а также высокая приверженность к препарату

СОВЕРШЕНСТВОВАНИЕ ТАКТИКИ БИОЦЕНОЗСБЕРЕГАЮЩЕЙ ТЕРАПИИ ПРИ ПРИМЕНЕНИИ АНТИБИОТИКОВ У ДЕТЕЙ С ОСТРЫМИ КИШЕЧНЫМИ ИНФЕКЦИЯМИ

50 children aged from 3 to 67 months with acute intestinal infections receiving antibiotic therapy, were clinically and microbiologically examined using gas-liquid chromatographic test with the measurement of short-chain fatty acids (SCFAs) in coprofiltrates. The influence on the biocenosis is assessed upon treatment with an-tidiarrhoeal medication Gelatin tannat (Adiarin), which acts by forming a protective film on the surface of intestinal mucosa preventing loss of body fluids and microbial toxins. 20 children in the control group received antibiotics, sorbents, probiotics. The study has proved the clinical effect of Gelatin tannat, resulting in reduction of time to normalization of diarrhea and intoxication for 2 days, and data on the probiotic effect of the drug, similar to that of probiotics in the control group which expands the indications for the use of Gelatin tannat for prevention of antibiotic-associated diarrhea.  Проведено клиническое и микробиологическое обследование с применением метода газожидкостной хроматографии (ГЖХ) с определением короткоцепочечных жирных кислот (КЖК) у 50 детей в возрасте от 3-х до 67 месяцев с ОКИ, получавших антибактериальную (АБ) терапию. Биоценозсохраняющая функция исследовалась на фоне применения противодиарейного средства Желатина танната (Адиарин), механизм действия которого основан на образовании на поверхности слизистой кишечника защитной пленки, препятствующей потери жидкости организмом и абсорбции микробных токсинов. В группе сравнения дети (20 пациентов) получали АБ, сорбенты, пробиотики. В результате исследования доказан клинический эффект Желатина танната, заключающийся в сокращении сроков нормализации стула и интоксикации на 2 дня, а также получены данные о пробиотическом эффекте препарата, аналогичном применению пробиотиков в группе сравнения, что расширяет показания к применению Желатина танната для профилактики антибиотикоассоциированных диарей. 

Efficiency assessment of probiotics for children on complex therapy of acute respiratory syndrome with gastrointestinal disorder at out-patient’s clinics

Background. The combined pathology of acute respiratory syndrome with gastrointestinal disorder is highly relevant. At this moment there were only a few studies for children on the subjects of the role of respiratory viruses and gastrointestinal pathogens with examination the materials (oropharynx and intestines). That’s why the certain role of particular pathogens in their combination are not completely determined.Objectives. The purpose of the study was to determine the role of viruses for children with acute respiratory syndrome with gastrointestinal disorder, depending on age and time of year in the period of COVID-pandemic. To evaluate the efficacy of the popular oral probiotics (oil drops dosage form) based on the results of clinical and laboratory tests in the complex therapy of acute respiratory syndrome with gastrointestinal disorder.Materials and methods. An open prospective observational study was conducted at out-patient’s clinics in the period of COVID-pandemic (04.2022-04.2023) and involved 100 children at the age of 1 month to 18 years. All children were examined on the subject of nucleic acids viruses (multiplex PCR diagnostics) from the oropharynx and feces. Additionally, there were evaluated the efficacy of probiotics. Group 1 (n = 50) received Adiarin® Probio at a dose of 6 drops 1-2 times a day. Group 2 (n = 50) received BioGaia® at a dose of 5 drops 1-2 times a day.Results. The results of the study showed high efficiency and sensitivity of the conducted probiotic therapy. However, for group 1, there was established greater sensitivity in viral infections management based on the test results of pharyngeal and fecal materials. At the same time, the width (95%) confidence interval of the Group 1 was less than for the Group 2, which means greater statistical reliability for the results interpretation.Conclusion. The study revealed differences in the seasonal circulation of viruses ib the period of COVID-pandemic, the change of the main pathogens in the oropharynx and feces. From the point of view of clinical practice, it is worth giving preference to probiotics which let treat patients shorter and need less number of additional medicines, as a result it means less drug and economic overloading for patients