Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: A randomized double-blind placebo-controlled trial

ArticleinAlimentary Pharmacology & Therapeutics 21(5):583-90 · April 2005with78 Reads
DOI: 10.1111/j.1365-2036.2005.02356.x · Source: PubMed
Co-treatment with Saccharomyces boulardii appears to lower the risk of antibiotic-associated diarrhoea in adults receiving broad-spectrum antibiotics. To determine whether S. boulardii prevents antibiotic-associated diarrhoea in children. A total of 269 children (aged 6 months to 14 years) with otitis media and/or respiratory tract infections were enrolled in a double-blind, randomized placebo-controlled trial in which they received standard antibiotic treatment plus 250 mg of S. boulardii (experimental group, n = 132) or a placebo (control group, n = 137) orally twice daily for the duration of antibiotic treatment. Analyses were based on allocated treatment and included data from 246 children. Patients receiving S. boulardii had a lower prevalence of diarrhoea (> or =3 loose or watery stools/day for > or =48 h occurring during or up to 2 weeks after the antibiotic therapy) than those receiving placebo [nine of 119 (8%) vs. 29 of 127 (23%), relative risk: 0.3, 95% confidence interval: 0.2-0.7]. S. boulardii also reduced the risk of antibiotic-associated diarrhoea (diarrhoea caused by Clostridium difficile or otherwise unexplained diarrhoea) compared with placebo [four of 119 (3.4%) vs. 22 of 127 (17.3%), relative risk: 0.2; 95% confidence interval: 0.07-0.5]. No adverse events were observed. This is the first randomized-controlled trial evidence that S. boulardii effectively reduces the risk of antibiotic-associated diarrhoea in children.
    • "(Corthier et al., 1986; Czerucka et al., 2007). S. boulardii has been shown to improve the symptoms of Clostridium difficile associated diarrhea as well as reduce inflammation and alter the immune state and reactions in the gut, leading to its adoption as a treatment for C. difficile diarrhea (Buts et al., 1994; Castagliuolo et al., 1999; Kotowska et al., 2005; Villarruel et al., 2007). Some yeasts from kefir have also shown immunomodulatory activities. "
    [Show abstract] [Hide abstract] ABSTRACT: Kefir is a complex fermented dairy product created through the symbiotic fermentation of milk by lactic acid bacteria and yeasts contained within an exopolysaccharide and protein complex called a kefir grain. As with other fermented dairy products, kefir has been associated with a range of health benefits such as cholesterol metabolism and angiotensin-converting enzyme (ACE) inhibition, antimicrobial activity, tumor suppression, increased speed of wound healing, and modulation of the immune system including the alleviation of allergy and asthma. These reports have led to increased interest in kefir as a focus of research and as a potential probiotic-containing product. Here, we review those studies with a particular emphasis on the microbial composition and the health benefits of the product, as well as discussing the further development of kefir as an important probiotic product.
    Full-text · Article · May 2016
    • "Further support for recommending specific strains or formulations is garnered by clinical trials testing the effectiveness of Saccharomyces boulardii at preventing CDI when provided with antibiotics. Earlier studies indicate that S. boulardii is effective at preventing recurrent CDI [61,72] , while more recent studies have indicated that S. boulardii is not effective at preventing CDI [73,74]. Strain designations were not detailed in these publications further contributing to the overgeneralization of the effects (or lack thereof) of a probiotic species as a whole. "
    [Show abstract] [Hide abstract] ABSTRACT: Population: Due to the high morbidity and mortality and increasing incidence that coincides with antibiotic use, non-traditional therapeutics are ideal alternatives to current treatment methods and also provide an avenue towards prevention. Despite the need for alternative therapies to antibiotics and the safety of most probiotics on the market, researchers are inundated with regulatory issues that hinder the translational science required to push these therapies forward. This review discusses the regulatory challenges of probiotic research, expert opinion regarding the application of probiotics to C. difficile infection and the efficacy of probiotics in preventing this disease.
    Full-text · Article · May 2016
    • "Diarrhea can be: " infectious " -diarrhea caused by an infectious etiology; " acute " -an episode of diarrhea of <14 days; " persistent " is the diarrhea lasting >14 days and " chronic " -diarrhea that lasts >30 days [24]. Kotowska et al. [25] conclude that S. boulardii can be used as complementary treatment in children who are submitted to antibiotic therapy to prevent the occurrence of antibiotic-associated diarrhea. The effect of S. boulardii on the intestinal anaerobe microflora can explain the protective impact of this probiotic on the diarrheal diseases appearing in patients under exclusive enteral nutrition. "
    [Show abstract] [Hide abstract] ABSTRACT: The increasing interest in the consumption of products containing probiotics is the result of numerous researches on their beneficial influence on human health. The promising one includes the improvement of prevention of various gastrointestinal disorders, the enhancement of immune function and the prevention of recurrent respiratory infections. Probiotics are available in a wide range of products with different benefits. Understanding their functional properties is an important aspect of health and well-being claims. Future studies are necessary to demonstrate the safe character of probiotics. This paper reviews the main effects of probiotic strain S. cerevisiae var. boulardii on gastrointestinal disorders. It has a beneficial physiological effect by the reduction of gastro-intestinal discomfort. The administration of the yeast, alone or in combination with other treatment, shows anti-inflammatory and immuno-modulatory effects.
    Full-text · Article · Jun 2015 · Anaerobe
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