[A prospective randomized controlled study on probiotics for the prevention of antibiotic-associated diarrhea in infants and young children].

Objectives: To evaluate the preventive effects of Saccharomyces boulardii powder and tetragenous viable Bifidobacterium tablets on antibiotic-associated diarrhea (AAD) in infants and young children.

Methods: Children under three years old admitted to the Department of Pediatrics, Affiliated Hospital of Xuzhou Medical University due to non-gastrointestinal infections and requiring antibiotic treatment from July to December 2023 were enrolled. The children were randomly divided into a control group (n=47), a Saccharomyces boulardii group (n=70), and a Bifidobacterium group (n=65) using a random number table method. The control group received antibiotics and symptomatic supportive treatment according to relevant clinical guidelines. In addition to the treatment given to the control group, the Saccharomyces boulardii group and the Bifidobacterium group were respectively administered with Saccharomyces boulardii powder and tetragenous viable Bifidobacterium tablets. Based on the duration of probiotic use (7 days, 14 days, and 21 days), the Saccharomyces boulardii group was further divided into 7 d, 14 d, and 21 d subgroups, and similarly for the Bifidobacterium group. The incidence of AAD and ratio of cocci to bacilli in feces were compared among the groups after treatment.

Results: The incidence rate of AAD in both the Saccharomyces boulardii group and the Bifidobacterium group was lower than that in the control group (P<0.017). The duration of AAD and the length of hospital stay were shorter in the Saccharomyces boulardii and Bifidobacterium groups compared to the control group (P<0.05). In the control group, the ratio of cocci to bacilli in feces on days 7, 14, and 21 was higher than on day 1 (P<0.05). Within-group comparisons showed that the ratio of cocci to bacilli in feces on day 14 in the Bifidobacterium 14 d and 21 d groups were lower than on day 1 (P<0.05); and the ratios on day 14 in the control group, Saccharomyces boulardii 14 d group, Saccharomyces boulardii 21 d group, Bifidobacterium 14 d group, and Bifidobacterium 21 d group were lower than on day 7 (P<0.05). The ratios on day 21 in the control group and the Saccharomyces boulardii 21 d group were lower than on days 7 and 14 (P<0.05). Between-group comparisons indicated that on day 7, the ratios of cocci to bacilli in feces in the Saccharomyces boulardii 7 d, 14 d, 21 d groups, and Bifidobacterium 7 d, 14 d, 21 d groups were all lower than in the control group (P<0.05); on day 14, the ratios of cocci to bacilli in feces 14 d and 21 d groups were lower than in the control group and the Bifidobacterium 7 d group (P<0.05).

Conclusions: Both Saccharomyces boulardii and tetragenous viable Bifidobacterium can effectively improve gut microbiota and prevent the occurrence of AAD in infants and young children. Compared to short-term treatment, appropriately extending the duration of probiotic therapy can further improve the structure of gut microbiota.