益生菌预防80岁以上老年人抗生素相关性腹泻的临床研究

Clinical effect of probiotics in preventing antibiotic-associated diarrhea in elderly patients aged 80 and over

目的评估益生菌制剂对≥80岁的老年患者抗生素相关性腹泻(antibiotic-associated diarrhea,AAD)的预防作用。方法我们设计前瞻性、随机临床研究,纳入年龄≥80岁、入院后接受≥1种抗生素治疗的患者,随机分为2组。干预组在使用抗生素的同时予以酪酸梭菌肠球菌三联活菌片口服,对照组在使用抗生素时予以安慰剂口服。随访2月,观察并比较2组AAD的发生情况。结果共计153例患者入组。干预组AAD的发生率明显低于对照组(16.0%比30.8%,P=0.031);干预组AAD发生达峰时间较对照组延迟;对照组出现AAD时临床表现较干预组更重。结论酪酸梭菌肠球菌三联活菌片可降低≥80岁的老年患者AAD的发生率,减轻腹泻症状,缩短病程。

Objective To assess the efficacy of probiotics in preventing antibiotic-associated diarrhea（ AAD） in patients aged 80 and over. Methods A prospective,paralled group trial was performed,and patients aged ≥ 80,receiving one or more antibiotics were enrolled and randomly divided into two groups. Prevention group was treated with antibiotics and clostridium enterococcus triple viable tablets,and control group was treated with antibiotics and placebo. The incidence rate and severity of AAD was observed and compared between two groups. Results From September 2014 to October 2015,a total of 153 elderly patients with infection who had received antibiotics were randomized to two groups.The incidence rate of AAD in the prevention group was significantly lower than that in the control group（ 16. 0% vs 30. 8%,P =0. 031）. Duration of development of AAD in prevention group was later than that in control group. Clinical manifestations were more severe in the control group. Conclusions Simultaneous use of clostridium enterococcus triple viable tablets can reduce the incidence of AAD,and alleviate the symptoms of diarrhea.