Probiotics as prevention for gastro-intestinal disorders in pediatrics


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Abstract

The gastro-intestinal microbiome is a hot topic in clinical research. Beneficial effects of selected probiotics in the prevention of gastrointestinal disorders are mainly limited to acute gastroenteritis, antibiotic-associated diarrhea, infantile colic and necrotizing enterocolitis. However, there is no broad consensus to recommend the use of probiotics in the prevention of these conditions, mainly because of the different design of the multiple studies, resulting in a limited evidence for specific strains and dosages and indications. More well-designed studies are needed before recommendations can be proposed. At this stage, there is insufficient evidence to recommend the routine use of probiotics in infants and children for the prevention of gastro-intestinal disorders.

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About the authors

Celine Perceval

KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel

Brussels, Belgium

Michel Pletincx

CHIREC, St-Anne St-Remi

Brussels, Belgium

Yvan Vandenplas

KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel

Email: yvan.vandenplas@uzbrussel.be
Brussels, Belgium

References

  1. Cani PD. Human gut microbiome: hopes, threats and promises. Gut. 2018; 67 (9): 1716-25.
  2. Dominguez-Bello MG. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA 2010; 107: 11971-5.
  3. Yasmin F. Cesarean section, formula feeding, and infant antibiotic exposure: separate and combined impacts on gut microbial changes in later infancy. Front Pediatr 2017; 5: 200.
  4. Odamaki T, Kato K, Sugahara H et al. Age-related changes in gut microbiota composition from newborn to centenarian: a cross-sectional study. BMC Microbiol 2016; 16: 90.
  5. Mitre E, Susi A, Kropp LE, Schwartz DJ et al. Association between use of acid-suppressive medications and antibiotics during infancy and allergic diseases in early childhood. JAMA Pediatr 2018; 172: e180315.
  6. Maier L, Pruteanu M, Kuhn M et al. Extensive impact of non-antibiotic drugs on human gut bacteria. Nature 2018; 555: 623-8.
  7. Vandeputte D, Falony G, Vieira-Silva S et al. Stool consistency is strongly associated with gut microbiota richness and composition, enterotypes and bacterial growth rates. Gut 2016; 65: 57-62.
  8. Lewis ZT, Totten SM, Smilowitz JT et al. Maternal fucosyltransferase 2 status affects the gut bifidobacterial communities of breastfed infants. Microbiome 2015; 3: 13.
  9. Reid G, Kumar H, Khan AI et al. The case in favour of probiotics before, during and after pregnancy: insights from the first 1,500 days. Benef Microbes 2016; 7: 353-62.
  10. Andersen SS, Michaelsen KF, Laursen RP et al. Why parents are skeptical about using probiotics preventively for small children: a Danish qualitative study. BMC Complement Altern Med 2018; 18: 336.
  11. Fernandez L, Langa S, Martin V et al. The human milk microbiota: origin and potential roles in health and disease. Pharmacol Res 2013; 69: 1-10.
  12. Panduru M, Panduru NM, S l v stru CM et al. Probiotics and primary prevention of atopic dermatitis: a meta-analysis of randomized controlled studies. J Eur Acad Dermatol Venereol 2015; 29: 232-42.
  13. Simpson MR, Dotterud CK, Storm O et al. Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial. BMC Dermatol 2015; 15: 13.
  14. Fiocchi A, Pawankar R, Cuello-Garcia C et al. World Allergy Organization-McMaster University guidelines for allergic disease prevention (GLAD-P): probiotics. World Allergy Organ J 2015; 8: 4.
  15. Rather IA, Bajpai VK, Kumar S et al. Probiotics and atopic dermatitis: an overview. Front Microbiol 2016; 7: 507.
  16. Li L, Han Z, Niu X et al. Probiotic supplementation for prevention of atopic dermatitis in infants and children: a systematic review and meta-analysis. Am J Clin Dermatol 2018 (in press).
  17. Forsberg A, West CE, Prescott SL et al. Pre-and probiotics for allergy prevention: time to revisit recommendations? Clin Exp Allergy 2016; 46; 1506-21.
  18. Grev J, Berg M, Soll R. Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev 2018; 12: CD012519.
  19. Lo Vecchio A, Vandenplas Y, Benninga M et al. An international consensus report on a new algorithm for the management of infant diarrhoea. Acta Paediatr 2016; 105: e384-9.
  20. Chouraqui JP, Van Egroo LD, Fichot MC. Acidified milk formula supplemented with bifidobacterium lactis: impact on infant diarrhea in residential care settings. J Pedi-atr Gastroenterol Nutr 2004; 38: 288-92.
  21. Hojsak I, Mo i Pavi A, Kos T et al. Bifidobacterium animalis subsp. lactis in prevention of common infections in healthy children attending day care centers - Randomized, double blind, placebo-controlled study. Clin Nutr 2016; 35: 587-91.
  22. Sazawal S, Dhingra U, Hiremath G et al. Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, doubleblind, controlled trial. PLoS One 2010; 5: e12164.
  23. Laursen RP, Larnkj«r A, Ritz C et al. Probiotics and child care absence due to infections: a randomized controlled trial. Pediatrics 2017; 140: pii: e20170735.
  24. Bocquet A, Lachambre E, Kempf C et al. Effect of infant and follow-on formulas containing B lactis and galacto- and fructo-oligosaccharides on infection in healthy term infants. J Pediatr Gastroenterol Nutr 2013; 57: 180-7.
  25. Oberhelman RA, Gilman RH, Sheen P et al. A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. J Pediatr 1999; 134: 15-20.
  26. Schneider C, Illi M, Lotscher M et al. Isolation of Antibodies from Human Plasma, Saliva, Breast Milk, and Gastrointestinal Fluid. Methods Mol Biol 2017; 1643: 23-31.
  27. Freedman SB, Williamson-Urquhart S, Farion KJ et al. Multicenter trial of a combination probiotic for children with gastroenteritis. N Engl J Med 2018; 379: 2015-26.
  28. Schnadower D, Tarr PI, Casper TC et al. Lactobacillus rhamnosus GG versus placebo for acute gastroenteritis in children. N Engl J Med 2018; 379: 2002-14.
  29. Pedone CA, Arnaud CC, Postaire ER et al. Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract 2000; 54: 568-71.
  30. Weizman Z, Asli G, Alsheikh A. Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 2005; 115: 5-9.
  31. Gutierrez-Castrellon P, Lopez-Velazquez G, Diaz-Garcia L et al. Diarrhea in preschool children and Lactobacillus reuteri: a randomized controlled trial. Pediatrics 2014; 133: e904-9.
  32. Urbanska M, Szajewska H. The efficacy of Lactobacillus reuteri DSM 17938 in infants and children: a review of the current evidence. Eur J Pediatr 2014; 173: 1327-37.
  33. Saavedra JM, Bauman NA, Oung I et al. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet 1994; 344: 1046-9.
  34. Hojsak I, Toki Pivac V, Mocic Pavi A et al. Bifidobacterium animalis subsp. lactis fails to prevent common infections in hospitalized children: a randomized, doubleblind, placebo-controlled study. Am J Clin Nutr 2015; 101: 680-4.
  35. Szajewska H, Kotowska M, Mrukowicz JZ et al. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr 2001; 138: 361-5.
  36. Mastretta E, Longo P, Laccisaglia A et al. Effect of Lactobacillus GG and breast-feeding in the prevention of rotavirus nosocomial infection. J Pediatr Gastroenterol Nutr 2002; 35: 527-31.
  37. Bruzzese E, Fedele MC, Bruzzese D et al. Randomised clinical trial: a Lactobacillus GG and micronutrient-containing mixture is effective in reducing nosocomial infections in children, vs. placebo. Aliment Pharmacol Ther 2016; 44: 568-75.
  38. Wanke M, Szajeweska H. Probiotics for preventing healthcare-associated diarrhea in children: A meta-analysis of randomized controlled trials. Pediatr Pol 2014; 89: 8-16.
  39. Trivi I, Hojsak I. Use of probiotics in the prevention of nosocomial infections. J Clin Gastroenterol 2018; 52 (Suppl. 1): S62-5.
  40. Urbanska M, Gieruszczak-Bialek D, Szymanski H et al. Effectiveness of Lactobacillus reuteri DSM 17938 for the prevention of nosocomial diarrhea in children: A randomized, double-blind, placebo-controlled trial. Pediatr Infect Dis J 2016; 35: 142-5.
  41. Wanke M, Szajewska H. Lack of an effect of Lactobacillus reuteri DSM 17938 in preventing nosocomial diarrhea in children: a randomized, double-blind, placebo-controlled trial. J Pediatr 2012; 161: 40-3.
  42. Hojsak I, Szajewska H, Canani RB et al. Probiotics for the Prevention of nosocomial diarrhea in children. J Pediatr Gastroenterol Nutr 2018; 66: 3-9.
  43. Cameron D, Hock QS, Kadim M et al. Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region. World J Gastroenterol 2017; 23: 7952-64.
  44. Guandalini S. Probiotics for prevention and treatment of diarrhea. J Clin Gastroenterol 2011; 45: S149-53.
  45. Fox MJ, Ahuja KD, Robertson IK et al. Can probiotic yogurt prevent diarrhoea in children on antibiotics? A double-blind, randomised, placebo-controlled study. BMJ Open 2015; 5: e006474.
  46. Olek A, Woynarowski M, Ahren IL et al. Efficacy and safety of Lactobacillus plantarum DSM 9843 (LP299V) in the prevention of antibiotic-associated gastrointestinal symptoms in children-randomized, double-blind, placebo-controlled study. J Pedi-atr 2017; 186: 82-6.
  47. Kolodziej M, Szajewska H. Lactobacillus reuteri DSM 17938 in the prevention of antibiotic-associated diarrhoea in children: a randomized clinical trial. Clin Microbiol Infect 2018; pii: S1198-743X (18)30591-3
  48. Shan LS, Hou P, Wang ZJ et al. Prevention and treatment of diarrhoea with Saccha-romyces boulardii in children with acute lower respiratory tract infections. Benef Microbes 2013; 4: 329-34.
  49. Johnston BC, Goldenberg JZ, Parkin PC. Probiotics and the Prevention of Antibiotic-Associated Diarrhea in Infants and Children. JAMA 2016; 316: 1484-5.
  50. Goldenberg JZ, Lytvyn L, Steurich J et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 2015; 12: CD004827.
  51. Goldenberg JZ, Yap C, Lytvyn L et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev 2017; 12: CD006095.
  52. Szajewska H, Kolodziej M. Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Aliment Pharmacol Ther 2015; 42: 1149-57.
  53. Goldenberg JZ, Mertz D, Johnston BC. Probiotics to prevent Clostridium difficile infection in patients receiving antibiotics. JAMA 2018; 320: 499-500.
  54. Szajewska H, Canani RB, Guarino A et al. ESPGHAN Working Group for Probiotics and Prebiotics. Probiotics for the prevention of antibiotic-associated diarrhea in children. J Pediatr Gastroenterol Nutr 2016; 62: 495-506.
  55. Mantegazza C, Molinari P, D'Auria E et al. Probiotics and antibiotic-associated diarrhea in children: A review and new evidence on Lactobacillus rhamnosus GG during and after antibiotic treatment. Pharmacol Res 2018; 128: 63-72.
  56. Dinleyici M, Vandenplas Y. Clostridium difficile colitis prevention and treatment In: Adv Exp Med Biol. New York, Springer, 2019.
  57. Vermeersch SJ, Vandenplas Y, Tanghe A et al. Economic evaluation of 6. boulardii CNCM I-745 for prevention of antibioticassociated diarrhoea in hospitalized patients. Acta Gastroenterol Belg 2018; 81: 269-76.
  58. Sung V. Infantile colic. Aust Prescr 2018; 41 (4): 105-10.
  59. Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. Am Fam Physician 2015; 92: 577-82.
  60. Sung V, D'Amico F, Cabana MD et al. Lactobacillus reuteri to treat infant colic: a meta-analysis. Pediatrics 2018; 141: e20171811.
  61. Harb T, Matsuyama M, David M et al. Infant colic-what works: a systematic review of interventions for breast-fed infants. J Pediatr Gastroenterol Nutr 2016; 62: 668-86.
  62. Indrio F, Di Mauro A, Riezzo G et al. Prophylactic use of a probiotic in the prevention of colic, regurgitation and functional constipation: a randomized clinical trial. JAMA Pediatr 2014; 168: 228-33.
  63. Savino F, Ceratto S, Poggi E et al. Preventive effects of oral probiotic on infantile colic: a prospective, randomised, blinded, controlled trial using Lactobacillus reuteri DSM 17938. Benef Microbes 2015; 6: 245-51.
  64. Indrio F, Di Mauro A, Di Mauro A et al. Prevention of functional gastrointestinal disorders in neonates: clinical and socioeconomic impact Benef Microbes 2015; 6: 195-8.
  65. Cabana MD, McKean M, Beck AL et al. Pilot analysis of early LGG for infant colic prevention. JPGN 2019; 68: 17-9.
  66. Giglione E, Prodam F, Bellone S et al. The association of bifidobacterium breve br03 and b632 is effective to prevent colics in bottle-fed infants: a pilot, controlled, randomized, and double-blind study. J Clin Gastroenterol 2016; 50 (Suppl. 2): S164-S167.
  67. Grave GD, Nelson SA, Walker WA et al. New therapies and preventive approaches for necrotizing enterocolitis: report of a research planning workshop. Pediatr Res 2007; 62: 510-4.
  68. Neu J, Walker WA. Necrotizing Enterocolitis. N Engl J Med 2011; 20: 255-64.
  69. Claud EC, Walker WA Hypothesis: inappropriate colonization of the premature intestine can cause neonatal necrotizing enterocolitis. FASEB J 2001; 15: 1398-403.
  70. Morowitz MJ, Poroyko V, Caplan M et al. Redefining the role of intestinal microbes in the pathogenesis of necrotizing enterocolitis. Pediatrics 2010; 125: 777-85.
  71. Schwiertz A, Gruhl B, Lbbnitz M et al. Development of the intestinal bacterial composition in hospitalized preterm infants in comparison with breast-fed, full-term infants. Pediatr Res 2003; 54: 393-9.
  72. Collado MC, Rautava S, Aakko J et al. Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid. Sci Rep 2016; 6: 23129.
  73. Heida FH, van Zoonen AG, Hulscher JB et al. A necrotizing enterocolitis-associated gut microbiota is present in the meconium: results of a prospective study. Clin Infect Dis 2016; 62: 863-70.
  74. Zhu XL, Tang XG, Qu F et al. Bifidobacterium may benefit the prevention of necrotizing enterocolitis in preterm infants: A systematic review and meta-analysis. Int J Surg 2019; 61: 17-25.
  75. Kane AF, Bhatia AD, Denning PW et al. Routine supplementation of Lactobacillus rhamnosus GG and risk of necrotizing enterocolitis in very low birth weight infants. J Pediatr 2018; 195: 73-9.
  76. Patel S, Chaudhari M, Kadam S et al. Standardized feeding and probiotic supplementation for reducing necrotizing enterocolitis in preterm infants in a resource limited set up. Eur J Clin Nutr 2018; 72: 281-7.
  77. Van den Akker CHP, van Goudoever JB, Szajewska H et al. Probiotics for preterm infants: a strain-specific systematic review and network meta-analysis. J Pediatr Gastroenterol Nutr 2018; 67: 103-22.
  78. Pell LG, Loutet MG, Roth DE et al. Arguments against routine administration of probiotics for NEC prevention. Curr Opin Pediatr 2019.
  79. Sanders ME, Benson A, Lebeer S et al. Shared mechanisms among probiotic taxa: implications for general probiotic claims. Curr Opin Biotechnol 2018; 49: 207-16.
  80. Athalye-Jape G, Patole S. Probiotics for preterm infants - time to end all controversies. Microb Biotechnol 2019; 12: 249-53.
  81. Escribano E, Zozaya C, Madero R et al. Increased incidence of necrotizing enterocolitis associated with routine administration of Infloran™ in extremely preterm infants. Benef Microbes 2018; 9: 683-90.
  82. Garofoli F, Civardi E, Indrio F et al. The early administration of Lactobacillus reuteri DSM 17938 controls regurgitation episodes in full-term breastfed infants. Int J Food Sci Nutr 2014; 65: 646-8.
  83. Indrio F, Riezzo G, Raimondi F et al. Lactobacillus reuteri accelerates gastric emptying and improves regurgitation in infants. Eur J Clin Invest 2011; 41: 417-22.
  84. Vandenplas Y, Analitis A, Tziouvara C et al. Safety of a new synbiotic starter formula. Pediatr Gastroenterol Hepatol Nutr 2017; 20: 167-77.
  85. Belei O, Olariu L, Dobrescu A et al. Is it useful to administer probiotics together with proton pump inhibitors in children with gastroesophageal reflux? J Neuroga-stroenterol Motil 2018; 24: 51-7.
  86. Koppen IJ, Benninga MA, Tabbers MM. Is there a role for pre-, pro- and synbiotics in the treatment of functional constipation in children? A systematic review. J Pedi-atr Gastroenterol Nutr 2016; 63 (Suppl. 1): S27-35.
  87. Huang R, Hu J. Positive effect of probiotics on constipation in children: a systematic review and meta-analysis of six randomized controlled trials. Front Cell Infect Microbiol 2017; 7: 153.
  88. Fang HR, Zhang GQ, Cheng JY, Li ZY. Efficacy of Lactobacillus-supplemented triple therapy for Helicobacter pylori infection in children: a meta-analysis of randomized controlled trials. Eur J Pediatr 2019; 178: 7-16.
  89. Szajewska H, Horvath A, Kolodziej M. Systematic review with meta-analysis: Sac-charomyces boulardii supplementation and eradication of Helicobacter pylori infection. Aliment Pharmacol Ther 2015; 41: 1237-45.
  90. Hegar B, Hutapea EI, Advani N et al. A double-blind placebo-controlled randomized trial on probiotics in small bowel bacterial overgrowth in children treated with omeprazole. J Pediatr (Rio J) 2013; 89: 381-7.
  91. Wegh CAM, Benninga MA, Tabbers MM. Effectiveness of probiotics in children with functional abdominal pain disorders and functional constipation: a systematic review. J Clin Gastroenterol 2018; 52 (Suppl. 1): S10-S26.
  92. Guandalini S, Magazzu G, Chiaro A et al. VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study J Pediatr Gastroenterol Nutr 2010; 51: 24-30.

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