益生菌预防成人抗生素相关性腹泻的荟萃分析

目的:探讨益生菌的使用与成人抗生素相关性腹泻(AAD)的关联,分析益生菌预防AAD的有效性及安全性.方法:系统检索PubMed,Embase,CINAHL,AMED,the Cochrane database of SystematicReviews,the Cochrane Controlled TrialsRegister和中国期刊全文数据库(CNKI),检索时间跨度从1966-01/2012-04.我们只纳入随机对照试验,研究对象>18周岁,研究内容为服用抗生素的同时服用益生菌预防AAD.结果:本研究结果表明,RR=0.45,95%CI:0.29-0.69,P<0.001,益生菌可以显著降低服用抗生素后发生腹泻的机率.基于益生菌种类的亚组分析的结果(RR=0.42,95%CI:0.20-0.85,P=0.003)同样证明了益生菌预防AAD的有效性.结论:益生菌可以显著降低服用抗生素后发生成人AAD的机率.

Probiotics for the prevention of antibiotic-associated diarrhea in adult patients:A metaanalysis

AIM:To systematically investigate whether current clinical trails can clarify the association between probiotic administration and adult antibiotic-associated diarrhea(AAD),and to evaluate the efficacy and safety of probiotic administration in preventing AAD in both inpatient and outpatient adults.METHODS:PubMed,Embase,CINAHL,AMED,the Cochrane database of Systematic Reviews,the Cochrane Controlled Trials Register,and the China National Knowledge Infrastructure(CNKI) electronic databases were searched for studies published between January 1966 and April 2012.Only prospective,randomized,controlled trials involving patients older than 18 years were included.Furthermore,only the trials which combinedantibiotic administration and probiotic therapy for the prevention of AAD were extracted.RESULTS:The data of the present study showed a significantly decreased risk of adult AAD:relative risk(RR) = 0.45,95% confidence interval(CI),0.29-0.69,P < 0.001.Similar results were obtained from the subgroup analysis of particular types of probiotics(RR = 0.42,95%CI:0.20-0.85,P = 0.003).CONCLUSION:Our study suggests that adult patients can benefit from probiotics co-administered with antibiotics.