DOI: http://dx.doi.org/10.22516/25007440.230

Probióticos en diarrea aguda, asociada a antibióticos y nosocomial: evidencia en pediatría

Sebastian Posada Bustos, Jose Fernando Vera Chamorro

Resumen


Introducción: Los probióticos son microorganismos vivos, que administrados en cantidades adecuadas proveen una acción benéfica en el ser humano. Existen numerosos estudios acerca de su uso en enfermedad diarreica en pediatría, por lo que se hace necesario evaluar la evidencia.

Métodos: Se realizó una revisión de la literatura incluyendo solo metaanálisis y revisiones sistemáticas en los últimos diez años acerca del uso de probióticos en diarrea aguda, diarrea asociada a antibióticos y Clostridium difficile y diarrea nosocomial.

Resultados: En diarrea aguda, metaanálisis muestran disminución de la duración en un día (IC 95%; 15,9 a 33,6 horas) y disminución del riesgo de prolongación en los siguientes 4 y 7 días, con recomendaciones fuertes y evidencia moderada para Lactobacillus rhamnosus GG y Saccharomyces boulardii. En diarrea asociada a antibióticos y a Clostridium difficile, los metanálisis muestran reducción del riesgo entre el 50-60%, con recomendación fuerte para Lactobacillus rhamnosus GG y Saccharomyces boulardii con un NNT de 10 (IC 95%; 7-12). En diarrea nosocomial se encontró evidencia moderada con el uso de Lactobacillus rhamnosus GG, principalmente en reducción del riesgo de gastroenteritis sintomática por rotavirus. Sin evidencia suficiente para dar recomendación para las cepas S. thermophiles y B. bifidum.

Conclusión: Sólo existe evidencia con los probióticos Lactobacillus rhamnosus GG  y Saccharomyces boulardii en reducción de la duración y disminución del riesgo de prolongación de diarrea aguda, así como reducción del riesgo entre 50-60% de diarrea asociada a antibióticos. Existe evidencia moderada con Lactobacillus rhamnosus GG, en la reducción de riesgo de diarrea nosocomial.


Palabras clave


Probióticos; pediatría; diarrea; antibióticos; infección hospitalaria

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Referencias


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ISSN versión impresa 0120-9957

ISSN versión en línea 2500-7440