Chemistry Reference
In-Depth Information
they tended to have greater bifidobacteria counts and fewer pathogenic clostridia,
but not salmonella.
32
The oligofructose-supplemented group had less flatulence and
fewer episodes of vomiting, diarrhea, and febrile episodes than the control group,
but the effects did not persist beyond the supplementation period. General immune
system enhancement has been demonstrated by Arslanoglu et al.
33
in a study, using a
mixture of neutral short-chain GOS and long-chain FOS. In this study, the incidence
of recurring infections, particularly respiratory infections, was decreased during the
first 6 months of life in the prebiotic group as compared to the placebo group.
Antibiotic use is frequent in children and at times leads to antibiotic-associated
diarrhea. Brunser et al.
34
conducted a randomized, double-blind study of the effects
of a prebiotic-supplemented formula given to a group of infants 1 to 2 years of age
receiving amoxicillin for acute bronchitis. They found that the antibiotic usage
decreased total fecal bacteria and increased clostridia; however, with prebiotic
supplementation there was increased fecal bifidobacteria and lactobacilli without
a change in gastrointestinal symptoms. Another common problem in infants is the
rising incidence of atopic dermatitis due to formula or breast milk intolerance. Many
children concurrently have gastrointestinal symptoms, such as vomiting, diarrhea,
and failure to thrive. Moro et al.
35
found that a mixture of GOS/FOS-supplemented
hydrolyzed formula given to infants at high risk for atopy reduced the incidence of
atopic dermatitis including regurgitation and crying during the first 6 months of life
as compared to the unsupplemented group.
13.5.2 Probiotics
The use of probiotics in the treatment of acute diarrheas, particularly viral diar-
rhea, has been extensively studied by several groups in placebo-controlled studies
in both Europe and the United States. In these studies,
Lactobacillus
GG
, L. reu-
teri, L. acidophilus
Lb,
Saccharomyces boulardii,
and a combination product of
Streptococcus thermophilus, L. acidophilus,
and
L. bulgaricus
led to decreased
severity and duration of diarrhea in both developed and in developing countries
when administered alone or as part of oral rehydration therapy. Four meta-analy-
ses have concluded that probiotic therapy reduced the duration of acute diarrheal
illness by approximately 1 day.
36-39
The probiotic with the most consistent results
was
Lactobacillus
GG. Two studies have, however, demonstrated no benefit demon-
strated of
Lactobacillus
GG
in the treatment of acute diarrhea children with severe
diarrhea.
40,41
A study of
L. paracaseii
ST11 also noted no benefit in severe cases of
pediatric diarrhea; however, some benefit in less severe, nonrotavirus diarrhea was
noted.
42
The prevention of nosocomial infectious diarrhea may be affected by the use
of probiotics. A double-blind, randomized control trial using
Lactobacillus
GG in
children ages 1 to 36 months showed a significant reduction in the risk of rotavirus
gastroenteritis 2.2 percent versus 6.7 percent.
43
However, in a larger double-blind,
randomized study there was no statistically significant protective effect of the same
probiotic for nosocomial rotavirus infection.
44
Another randomized trial looking
at 55 infants admitted to a chronic care pediatric hospital showed a lower risk of
