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"Child`s Health" 4 (64) 2015

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On the issue of prevention of antibiotic-associated diarrhea in children

Authors: Kryuchko T.A., Nesinа I.M., Astakhova N.G., Voloshina V.V. - High State Educational Institution "Ukrainian Medical Stomatological Academy", Poltava, Ukraine.

Categories: Pediatrics/Neonatology

Sections: Specialist manual

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antibiotic-diarrhea, antibiotic therapy, respiratory pathology, children, kolifagina

Widespread use of antibiotics contributes significantly change the microbial landscape of the gastrointestinal tract, which manifests itself in the inhibition of intestinal commensal life, reducing external and internal layer of mucus and increase the permeability of the intestinal wall. Under the influence of antibiotics can occur transformation towards an increase in the transient population of the normal flora of individual species characterized by pathogenicity factors: increasing adhezyvnosti, high biochemical activity and enterotoksynproduktsiyeyu, polyvalent of drug resistance.

Results today metanaliziv convincingly argue that the use of probiotics reduces the frequency of ATA, but is not sufficient questions remain illuminated efficacy of specific strains dosing regimens. Despite the wide range of drugs with probiotic effect on the pharmaceutical market of Ukraine, most drugs are no results of clinical trials with proven efficacy and safety of use in children.

The aim of our study was to evaluate the effectiveness of preventive and therapeutic drug synbiotychnoho "Kolifahina PRO" against the background of antibiotic therapy for children with respiratory diseases.

Material and methods. The study included 30 children (14 girls and 16 boys) aged 3 to 14 years: 10 children aged 3 to 6 years, 12 children aged 7-11 years and 12-14 years 8 patients (average age - 7, 96 + 4.49) years. Sick children were hospitalized in a pulmonology department of the Children's City Clinical Hospital Poltava. All patients were examined by a single protocol with informed consent of parents.

All patients as probiotic correction received synbiotychnyy drug "Kolifahina PRO". The main criteria preventive efficacy "Kolifahina PRO" considered the following indicators: the development of the ATA (at least three episodes of liquid stool for a day or more than three episodes of normal stool a day), the emergence of abdominal pain, stool changing nature - liquid or loose stools, rumbling in the abdomen, bloating, vomiting. All patients received the drug according to instructions: children over 3 years - one vial a day fasting for 10 days.

After 7 days of treatment with the inclusion of comprehensive synbiotic "Kolifahina PRO" patients was noted positive dynamics of clinical symptoms of microbiota. On day 10 of therapy, only 5 patients have noted mild symptoms of dysfunction of the bowel (constipation alternating with diarrhea, recurrent abdominal pain associated with defecation, flatulence) that caused the prolongation reception Kolifahiny defense. At the control bacteriological study, which was conducted just this group of patients noted a marked tendency to restore the microbial landscape of the intestine.

The study allows to confirm once again the concept that intestinal dysbiosis, increasing fermentation leads to increased concentration in the intestine of osmotically active substances that promotes bowel irritation, excessive flatulence, increased volume of intestinal contents and end - of diarrhea. The need for correcting violations in dysbiotic accompanied antibiotic no doubt.The need to correct violations dysbiotic accompanying antibiotic therapy is not in doubt. Inclusion in the complex therapy with antibiotics correction probiotic synbiotics "Kolifagina PRO" in patients with acute respiratory disorders in children allowed profilaktirovat AAD and contributed to a more rapid regression of the main symptoms of the disease, normalization of stool frequency and character.

Thus, the results of the study reaffirmed that potential risk factors for AAD in children are: preschool age, concomitant diseases of the gastrointestinal tract and allergic pathology, recurrent respiratory diseases who require repeat prescriptions antibiotics. Preventive courses probiotics in these patients may not only prevent the and reduce the risk of exacerbations and comorbidities allergic diseases and gastrointestinal tract.

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