Recommendations For The Adjuvant Use Of The Poly-antibiotic ...

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Abstract

This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Evidence-based recommendations and randomized controlled trials in the region are included. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by utilizing a modified Delphi process and applying the Likert scale in an electronic voting process. Bacillus clausii was recommended as an adjunct treatment with oral rehydration solution for acute viral diarrhea. B. clausii may also be considered for prevention of antibiotic-associated diarrhea, Clostridium difficile-induced diarrhea, and as adjunct treatment of Helicobacter pylori. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations currently apply to most Asia-Pacific countries. Ideally, these need to be validated with local randomized-controlled trials.

Keywords: Acute viral diarrhea; Antibiotic-associated diarrhea; Bacillus clausii; Chronic diarrhea; Clostridium difficile-associated diarrhea; Gastroenteritis; Helicobacter pylori infection; Pediatric diarrhea; Probiotics; Spores.

© The Author(s) 2020.

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Conflict of interest statement

Competing interestsAll authors have disclosed any conflicts of interest. The individual declarations are summarized below. MJG is a member of the SEA Advisory Board of Sanofi-Aventis; JDC is a speaker for Sanofi, Pediatrica and United Laboratories (Unilab Medical Education and Development); DK is a speaker for Nestlé, Danone, Sanofi, Abbott and Dr. Reddy’s Laboratories; KRL is a member of the Advisory Board and Key Opinion Leader of Sanofi, guest speaker for live and webinar meetings (international and national), and National Coordinator and Principal Investigator for research studies; SHQ was a member of the International Data Monitoring Committee (IDMC) for dengue vaccine of Sanofi. All authors received an honorarium from Sanofi for consultancy work. The authors did not receive any payment in relation to writing this publication.

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