PREDIJATRIJSKI ASPEKTI PRIMENE SACCHAROMYCES BOULARDI U SRBIJI
DOI:
https://doi.org/10.46793/PP170305015SKljučne reči:
Saccharomyces boulardi, dete, probiotikApstrakt
Uvod. U pedijatrijskoj praksi se najčešće koriste probiotici koji sadrže gljivicu Saccharomyces boulardii i bakterije iz grupe Lactobacillus ili Bifidobacterium. Vodiči za primenu probiotika kod dece preporučuju primenu Saccharomyces boulardii u slučaju akutnog gastroenteritisa, eradikacije Helicobacter pylori infekcije, prevencije dijareje udružene sa antibioticima i kod Clostridium difficile enterokolitisa.
Cilj rada.Cilj ovog rada je bio da se ispita moderni aspekt korišćenja Saccharomices Boulardii (Bulardi® Junior, Saccharomices boulardii DBVPG 6763, Abela Pharm, Srbija) u svakodnevnoj pedijatrijskoj praksi.
Metode rada Istraživanje je planirano kao studija preseka rada pedijatara u primarnoj zdravstvenoj zaštiti u Republici Srbiji.
Rezultati. Istraživanjem je obuhvaćen 3 461 ispitanik koji je dobijao navedeni probiotik. Najviše ispitanika je bilo predškolskog uzrasta (59.98%, n=2076), a potom nižeg školskog uzrasta 7-12 godina (15.00%, n=519), dok je najmanje bilo odojčadi (13.98%, n=484) i adolescenata (11.04%, n=382). Ispitanici se nisu statistički značajno razlikovali prema polu. Najčešća indikacija za prepisivanje probiotika je bila dijareja udružena sa antibioticima (64.69%, n=2239), a potom akutni gastroenteritis (34.21%, n=1184), dok su druge dve indikacije bile znatno ređe, Clostridium difficile enterokolitis (0.17%, n=6) i Helicobacter pylori infekcija (0.93%, n=32). Najčešće ordinirani antibiotici uz probiotik su bili penicilini (59.09%, n=2045) i cefalosporini (29.37%, n=1.017), dok su makrolidi, tetraciklini i sulfonamidi bili znatno ređe zastupljeni. U 93.70% (n=3243) slučajeva je Saccharomyces boulardii prepisivan u vidu jedne kapsule od 250 mg na dan. Dužina uzimanja probiotika je bila najčešće 14 dana (47.99%, n=1661).
Zaključak. Pedijatrijski aspekt primene probiotika sa monokulturom Saccharomices boulardii je podjednako korišćenje kod dece oba pola i u svim starosnim grupama dece, ali uglavnom kod dece između 1 i 6 godina. Najčešći indikacije za propisivanje ovog probiotika su dijareja povezana sa antibioticima i akutni gastroenteritis. Probiotik je korišćen sam ili u kombinaciji sa antibioticima, iz grupe penicilina ili cefalosorina.
Reference
Joint FAO/WHO Expert Consultation. Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria. Food Agric Organ United Nations World Heal Organ (Fao Who) [Internet]. 2001;(October):1–34. Available from: http://scholar.google.com/ scholar?hl=en&btnG=Search&q=intitle:Health+and+Nutritional+Properties+of+Probiotics+in+Food+including+Powder+Milk+with+Live+Lactic+Acid+Bacteria#2%5Cnhttp://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Health+and+Nutrit
Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol [Internet]. 2014;11(August 2014):9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24912386
Łukaszewicz M. Saccharomyces cerevisiae var. boulardii – Probiotic Yeast. Probiotics [Internet]. 2012;(March):385–98. Available from: http://cdn.intechopen.com /pdfs/39643/InTech-Saccharomyces_cerevisiae_var_ boulardii_probiotic_yeast.pdf
Buts JP, Bernasconi P, Van Craynest MP, Maldague P, De Meyer R. Response of human and rat small intestinal mucosa to oral administration of Saccharomyces boulardii. Pediatr Res [Internet]. 1986;20(2):192–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/3080730
Sougioultzis S, Simeonidis S, Bhaskar KR, Chen X, Anton PM, Keates S, et al. Saccharomyces boulardii produces a soluble anti-inflammatory factor that inhibits NF-κB-mediated IL-8 gene expression. Biochem Biophys Res Commun. 2006;343(1):69–76.
Buts J-P, Bernasconi P, Vaerman J-P, Dive C. Stimulation of secretory IgA and secretory component of immunoglobulins in small intestine of rats treated withSaccharomyces boulardii. Dig Dis Sci [Internet]. 1990;35(2):251–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/2302983
McFarland L V. Systematic review and meta-analysis of saccharomyces boulardii in adult patients. World J Gastroenterol. 2010;16(18):2202–22.
Sorini C, Falcone M. Shaping the (auto)immune response in the gut: the role of intestinal immune regulation in the prevention of type 1 diabetes. Am J Clin Exp Immunol [Internet]. 2013;2(2):156–71. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23885333%5Cnhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC3714176
Sundman E, Olofsson PS. Neural control of the immune system. AJP Adv Physiol Educ [Internet]. 2014;38(2):135–9. Available from: http://ajpadvan.physiology.org/cgi/doi/10.1152/advan.00094.2013
Kelesidis T, Pothoulakis C. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. Therap Adv Gastroenterol [Internet]. 2011;5(2):111–25. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3296087&tool=pmcentrez&rendertype=abstract
Rajilic-Stojanovic M, de Vos WM. The first 1000 cultured species of the human gastrointestinal microbiota. FEMS Microbiol Rev. 2014;38(5):996–1047.
Kotowska M, Albrecht P, Szajewska H. Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: A randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther. 2005;21(5):583–90.
Lau CS, Chamberlain RS. Probiotics are effective at preventing Clostridium difficile-associated diarrhea: A systematic review and meta-analysis. Int J Gen Med. 2016;9:27–37.
McFarland L V, Surawicz CM, Greenberg RN, Fekety R, Elmer GW, Moyer KA, et al. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA [Internet]. 1994;271(24):1913–8. Available from: http://www.shelep.msk.ru/?page_id=197
Surawicz CM, McFarland L V, Greenberg RN, Rubin M, Fekety R, Mulligan ME, et al. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin Infect Dis. 2000;31(4):1012–7.
Allen SJ, Martinez EG, Gregorio G V, Dans LF. Probiotics for treating acute infectious diarrhoea. In: Allen SJ, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2010. p. 125. Available from: http://doi.wiley.com/10.1002/14651858.CD003048.pub3
Kurugöl Z, Koturoğlu G. Effects of Saccharomyces boulardii in children with acute diarrhoea. Acta Paediatr. 2005;94(October 2003):44–7.
Guarino A, Albano F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R, et al. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: executive summary. J Pediatr Gastroenterol Nutr. 2008;46(5):619–21.
Szajewska H, Horvath A, Piwowarczyk A. Meta-analysis: The effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther. 2010;32(9):1069–79.
Szajewska H, Horvath A, Kołodziej M. Systematic review with meta-analysis: Saccharomyces boulardii supplementation and eradication of Helicobacter pylori infection. Aliment Pharmacol Ther [Internet]. 2015;41(12):1237–45. Available from: http://dx.doi.org/10.1111/apt.13214
Malfertheiner P, Megraud F, O’Morain CAC a., Atherton J, Axon ATR, Bazzoli F, et al. Management of Helicobacter pylori infection—the Maastricht IV/ Florence Consensus Report. Gut [Internet]. 2012;61(5):646–64. Available from: http://dx.doi.org/10.1136/gutjnl-2012-302084%5Cnhttp://gut.bmj.com/content/61/5/646.abstract
Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut [Internet]. 2017;66(1):6–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27707777
Guarner F, Khan AG, Garisch J, Eliakim R, Gangl A, Krabshuis J, et al. Probiotics and prebiotics. Probiotics prebiotics-World Gastroenterol Organ Glob Guidel [Internet]. 2011;(October):1–28. Available from: http://www.worldgastroenterology.org /assets/export/userfiles/Probiotics_FINAL_20110116.pdf
Dragana Skokovic-Sunjic. Clinical Guide to PROBIOTIC SUPPLEMENTS AVAILABLE IN CANADA: 2016 Edition. 2016;
Ritchie ML, Romanuk TN. A meta-analysis of probiotic efficacy for gastrointestinal diseases. PLoS One. 2012;7(4).
Erdeve O, Tiras U, Dallar Y. The probiotic effect of Saccharomyces boulardii in a pediatric age group. J Trop Pediatr [Internet]. 2004;50(4):234–6. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=15357564&site=ehost-live
Tang N, Luo NJ. A cross-sectional study of intestinal parasitic infections in a rural district of west China. Can J Infect Dis [Internet]. 2003;14(3):159–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18159450