A practical guide for probiotics applied to the case of antibiotic-associated diarrhea in The Netherlands

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amoxicillin 5 infectiousdiseasesdrugs
clindamycin 1 infectiousdiseasesdrugs
diarrhea 33 infectiousdiseases

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amoxicillin 3945 low-prescribing country like the Netherlands (Fig. 1) [[9]]. For example, the broad-spectrum antibiotic amoxicillin is one of the top 25 drugs that have increased in the numbers of prescriptions in 2015 [[10]]. Therefore,
amoxicillin 14733 the trial. Six studies (9%) used only one antibiotic or combination of antibiotics: two studies used amoxicillin , one used amoxicillin with clavulanic acid, one used a non-specified beta-lactam antibiotic, and two
amoxicillin 14755 (9%) used only one antibiotic or combination of antibiotics: two studies used amoxicillin, one used amoxicillin with clavulanic acid, one used a non-specified beta-lactam antibiotic, and two used a combination of
amoxicillin 15117 antibiotics. All of these studies included antibiotics associated with a high risk of AAD, including amoxicillin , beta-lactams, broad-spectrum penicillins, cephalosporins and clindamycin. Ten studies focused on children
amoxicillin 22854 the probiotic they tested (Saccharomyces boulardii) may be effective in preventing diarrhea caused by amoxicillin with clavulanate and by intravenous ceforuxime, but they also mentioned that they could not make definitive
clindamycin 15191 high risk of AAD, including amoxicillin, beta-lactams, broad-spectrum penicillins, cephalosporins and clindamycin . Ten studies focused on children up to 17 years old (of which one focused on infants 6–36 months),
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diarrhea 105 Title: BMC GastroenterologyA practical guide for probiotics applied to the case of antibiotic-associated diarrhea in The NetherlandsValeria AgamennoneCyrille A. M. KrulGer RijkersRemco KortPublication date (epub):
diarrhea 334 date (pmc-release): 8/2018Publication date (collection): /2018AbstractBackgroundAntibiotic-associated diarrhea (AAD) is a side-effect frequently associated with the use of broad spectrum antibiotics. Although a
diarrhea 1347 with randomized, double blind placebo-controlled trials, a clear definition of antibiotic associated diarrhea , and a probiotic administration regime for at least the duration of the antibiotic therapy.ResultsUsing
diarrhea 2707 contains supplementary material, which is available to authorized users.BackgroundAntibiotic associated diarrhea (AAD)The use of antibiotics is associated with a variety of side-effects. The most common side effects
diarrhea 2861 with a variety of side-effects. The most common side effects are gastro-intestinal, such as nausea and diarrhea (Additional file 1). Antibiotic-associated diarrhea (AAD) arises when the antibiotic disrupts the ecology
diarrhea 2913 effects are gastro-intestinal, such as nausea and diarrhea (Additional file 1). Antibiotic-associated diarrhea (AAD) arises when the antibiotic disrupts the ecology of the intestinal microbiota, by altering the
diarrhea 4712 effect of probiotics on gut health in a variety of conditions (antibiotic-associated and infectious diarrhea , irritable bowel syndrome, necrotizing enterocolitis, etc.) has been evaluated by a number of randomized
diarrhea 6645 paper we present a practical guide to the use of probiotics for the prevention of antibiotic-associated diarrhea . The guide is based on available scientific evidence and developed by following a workflow in three
diarrhea 7464 studies that assessed the efficacy of probiotics in reducing the incidence of antibiotic-associated diarrhea (AAD) in patients treated with antibiotics, regardless of their age, of the intervention setting (hospital
diarrhea 8250 CDSR databases we searched combinations of the following terms: “probiotic”, “antibiotic”, “ diarrhea ” and “antibiotic-associated diarrhea”. The search yielded 25 results from the DARE and 50 from
diarrhea 8291 the following terms: “probiotic”, “antibiotic”, “diarrhea” and “antibiotic-associated diarrhea ”. The search yielded 25 results from the DARE and 50 from the CDSR. In PubMed, we searched for meta-analyses
diarrhea 8534 search texts: “((probiotic[Title/Abstract] OR probiotics[Title/Abstract]) AND (antibiotic associated diarrhea [Title/Abstract] OR antibiotic-associated diarrhea[Title/Abstract] OR antibiotic associated diarrhoea[Title/Abstract]
diarrhea 8584 probiotics[Title/Abstract]) AND (antibiotic associated diarrhea[Title/Abstract] OR antibiotic-associated diarrhea [Title/Abstract] OR antibiotic associated diarrhoea[Title/Abstract] OR antibiotic-associated diarrhoea[Title/Abstract]))”,
diarrhea 8752 diarrhoea[Title/Abstract] OR antibiotic-associated diarrhoea[Title/Abstract]))”, which yielded 28 results; and “(( diarrhea [Title/Abstract] OR diarrhoea[Title/Abstract]) AND (probiotic[Title/Abstract] OR probiotics[Title/Abstract])
diarrhea 9526 the period 2010–2017. We used the following search texts: “probiotic AND antibiotic associated diarrhea OR antibiotic associated diarrhoea” and “probiotic AND antibiotic AND diarrhea”. These searches
diarrhea 9609 antibiotic associated diarrhea OR antibiotic associated diarrhoea” and “probiotic AND antibiotic AND diarrhea ”. These searches yielded 26 studies.Among the studies resulting from our searches, we defined the
diarrhea 10132 that did not meet the above inclusion criteria were excluded. Furthermore, we excluded studies when diarrhea was already present at the start of the intervention and when the probiotics were tested in combination
diarrhea 10963 trials, we calculated the relative risk (RR) and the 95% confidence interval (CI) for the incidence of diarrhea in the probiotic versus placebo treatment. In addition, we conducted a subgroup analysis by pooling
diarrhea 14480 definition of AAD (20%). Among other reasons for exclusion were the lack of a precise measurement of diarrhea , and an unclear duration of the probiotic treatment.From the total of 32 included studies, five (15.6%)
diarrhea 15845 Additional file 4. Overall, probiotics were associated with lower incidence of antibiotic-associated diarrhea (467/3720 [13%]) compared to the control (648/3640 [18%]) (RR 0.66, 95% CI 0.64–0.67). For trials
diarrhea 16191 95% CI 0.95–1.07). For trials including food supplements (i.e. non-dairy products) the incidence of diarrhea in the probiotic group was 12.2% compared to 16.3% in the control group (RR 0.64, 95% CI 0.63–0.65).RecommendationsA
diarrhea 21427 criteriaIn this review we chose to only include studies that had a clear definition of antibiotic-associated diarrhea , to be able to compare their results in a systematic way. However, studies lacking a precise definition
diarrhea 21543 able to compare their results in a systematic way. However, studies lacking a precise definition of diarrhea may still provide valuable information, and it could be a subject for future discussions how to interpret
diarrhea 21773 whether to take them into account when formulating recommendations. Furthermore, the strict definition of diarrhea used in some studies means that the protective effect of probiotics against AAD may have been underestimated
diarrhea 22223 specific treatments, nor did we exclude studies that did not indicate which antibiotics they used, since diarrhea can be a side-effect of many. Five of the studies that we included did not specify which antibiotic
diarrhea 22835 [[65]] suggested that the probiotic they tested (Saccharomyces boulardii) may be effective in preventing diarrhea caused by amoxicillin with clavulanate and by intravenous ceforuxime, but they also mentioned that they
diarrhea 23282 small sample size (relative to the number of antibiotics tested) or because of the low incidence of diarrhea in the study, or both [[75], [82]]. Twenty-two of the studies included in this review included a power
diarrhea 23855 have enough power it would be possible to identify which probiotics are most effective in preventing diarrhea caused by specific antibiotics, and clinicians would be able to recommend different probiotic products
diarrhea 26094 here a study showing a positive effect of the probiotic dairy drink Actimel (Danone) in preventing diarrhea caused by antibiotics [[62]], and we subsequently included this product in the list of one-star recommendations.
diarrhea 28064 Lactobacillus rhamnosus GG, which has been repeatedly proven effective in reducing in the incidence of diarrhea in antibiotic-treated patients and in treating other gastrointestinal disorders [[88]]. Different strains
diarrhea 32812 workflow for the assessment of the efficacy of probiotics for the prevention of antibiotic-associated diarrhea . The workflow consists of a series of steps (systematic review of available literature and meta-analysis
diarrhea 33510 recommendation for the use of specific probiotic products for the prevention of antibiotic associated diarrhea . In particular, we provide a three-star recommendation for preparations with a minimal daily dose of
diarrhea 34673 risk) is summarized. (XLSX 39 kb)Additional file 4:Probiotics for prevention of antibiotic-associated diarrhea (AAD) in 32 randomized, double-blind, placebo-controlled trials. Forest plot summarizing the results

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