JAMA:益生菌可以减少使用抗生素治疗的患者患艰难梭菌的风险

2018-07-29 MedSci MedSci原创

成人和儿童在使用抗生素治疗时易发生艰难梭菌感染,那么使用抗生素使用的同时使用益生菌治疗是否可以降低艰难梭菌的感染率呢,目前还没有有高质量的文献表明益生菌与较低的艰难梭菌感染风险相关,因此本项研究希望证明此项关系。

背景及目的:
成人和儿童在使用抗生素治疗时易发生艰难梭菌感染,那么使用抗生素使用的同时使用益生菌治疗是否可以降低艰难梭菌的感染率呢,目前还没有有高质量的文献表明益生菌与较低的艰难梭菌感染风险相关,因此本项研究希望证明此项关系。

方法:
本项研究是一项回顾性调查研究,共纳入了16个国家39个RCT研究数据,共有9955名患者被纳入本项研究,男性占52%,女性占48%,平均年龄为51岁,接受抗生素治疗的39箱研究中33项试验是关于成人的,6项研究是关于儿童的。益生菌包含一种或多种益生菌,包括酵母菌,乳酸杆菌,双歧杆菌和链球菌。主要观察结局是CDI的阳性检测率,次要观察结局是抗生素相关性腹泻。

结果:
益生菌和抗生素的共同给药与CDI与安慰剂或不治疗的风险较低相关(分别为70/4525 [1.5%] vs 164/4147 [4.0%];风险比[RR],0.40 [95%CI] ,0.30-0.52),P<.001),益生菌加抗生素与较低的不良事件风险相关,如腹部绞痛和恶心与安慰剂或不治疗(620/4329 [14.3%] vs 677/3976 [17.0%]; RR,0.83 [95%CI,0.71 to 0.97],P= .02)。与安慰剂或不治疗相比,益生菌加抗生素与抗生素相关性腹泻风险较低相关(565/4618 [12.2%] vs 771/4252 [18.1%]; RR,0.58 [95%CI,0.48~0.70],P<.001)

结论:
在31项比较抗生素和益生菌与安慰剂或不接受抗生素预防CDI治疗的研究中,益生菌与CDI,不良事件和抗生素相关性腹泻的风险较低相关。在具有高基线CDI风险(> 5%)的试验中发现益生菌使用与CDI风险之间存在统计学显着相关性。然而,CDI风险为3%至5%的亚组可能效力不足。

原始出处:

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  1. [GetPortalCommentsPageByObjectIdResponse(id=336720, encodeId=8af9336e20da, content=益生菌对肠道健康有益。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Mon Aug 06 00:20:39 CST 2018, time=2018-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335481, encodeId=f8b733548120, content=益生菌能起到抗生素达不到的效果。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Wed Aug 01 08:26:41 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345230, encodeId=2c46134523083, content=<a href='/topic/show?id=cd305543152' target=_blank style='color:#2F92EE;'>#抗生素治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55431, encryptionId=cd305543152, topicName=抗生素治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/D2FD7704B41C9E22364B1E54ABB223BB/100, createdBy=1df22500220, createdName=ms1260584454294838, createdTime=Mon Jul 30 15:09:00 CST 2018, time=2018-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335038, encodeId=21ed33503852, content=谢谢了,学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Mon Jul 30 06:48:23 CST 2018, time=2018-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=334901, encodeId=33e833490136, content=不错了,学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Sun Jul 29 11:58:56 CST 2018, time=2018-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=334838, encodeId=37cd334838f3, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sun Jul 29 07:10:29 CST 2018, time=2018-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=334818, encodeId=659e334818bc, content=学习学习再学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Sun Jul 29 06:08:35 CST 2018, time=2018-07-29, status=1, ipAttribution=)]
    2018-08-06 liumin1987

    益生菌对肠道健康有益。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=336720, encodeId=8af9336e20da, content=益生菌对肠道健康有益。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Mon Aug 06 00:20:39 CST 2018, time=2018-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335481, encodeId=f8b733548120, content=益生菌能起到抗生素达不到的效果。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Wed Aug 01 08:26:41 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345230, encodeId=2c46134523083, content=<a href='/topic/show?id=cd305543152' target=_blank style='color:#2F92EE;'>#抗生素治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55431, encryptionId=cd305543152, topicName=抗生素治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/D2FD7704B41C9E22364B1E54ABB223BB/100, createdBy=1df22500220, createdName=ms1260584454294838, createdTime=Mon Jul 30 15:09:00 CST 2018, time=2018-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335038, encodeId=21ed33503852, content=谢谢了,学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Mon Jul 30 06:48:23 CST 2018, time=2018-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=334901, encodeId=33e833490136, content=不错了,学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Sun Jul 29 11:58:56 CST 2018, time=2018-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=334838, encodeId=37cd334838f3, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sun Jul 29 07:10:29 CST 2018, time=2018-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=334818, encodeId=659e334818bc, content=学习学习再学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Sun Jul 29 06:08:35 CST 2018, time=2018-07-29, status=1, ipAttribution=)]
    2018-08-01 liumin1987

    益生菌能起到抗生素达不到的效果。

    0

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    2018-07-30 txqjm

    谢谢了,学习

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=336720, encodeId=8af9336e20da, content=益生菌对肠道健康有益。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Mon Aug 06 00:20:39 CST 2018, time=2018-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335481, encodeId=f8b733548120, content=益生菌能起到抗生素达不到的效果。, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Wed Aug 01 08:26:41 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345230, encodeId=2c46134523083, content=<a href='/topic/show?id=cd305543152' target=_blank style='color:#2F92EE;'>#抗生素治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55431, encryptionId=cd305543152, topicName=抗生素治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/D2FD7704B41C9E22364B1E54ABB223BB/100, createdBy=1df22500220, createdName=ms1260584454294838, createdTime=Mon Jul 30 15:09:00 CST 2018, time=2018-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=335038, encodeId=21ed33503852, content=谢谢了,学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Mon Jul 30 06:48:23 CST 2018, time=2018-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=334901, encodeId=33e833490136, content=不错了,学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Sun Jul 29 11:58:56 CST 2018, time=2018-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=334838, encodeId=37cd334838f3, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sun Jul 29 07:10:29 CST 2018, time=2018-07-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=334818, encodeId=659e334818bc, content=学习学习再学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Sun Jul 29 06:08:35 CST 2018, time=2018-07-29, status=1, ipAttribution=)]
    2018-07-29 owlhealth

    不错了,学习啦

    0

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    2018-07-29 龙胆草

    学习谢谢分享

    0

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    2018-07-29 yjs木玉

    学习学习再学习

    0

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