The effectiveness of the use of synbiotics in the complex therapy of acute intestinal infections in children

Relevance. Acute intestinal infections in children retain a high value in the structure of child morbidity and mortality, which necessitates the search for means and methods for their active treatment and improvement of prognosis.

Aim: to determine the effectiveness of the use of synbiotics in the complex therapy of acute intestinal infections in children at the outpatient stage.

Materials and methods. Fifty 6–17 years children with mild or moderate acute intestinal infections were examined. The patients were divided into the main group (30 children) and the control group (20 children), the groups were comparable. Patients from the main group, along with pathogenetic therapy, received a combination of Lacticaseibacillus paracasei DG I-1572 DSM 34154
(L. casei DG) and fructooligosaccharides (FOS), and children from the control group received only pathogenetic and symptomatic treatment. Clinical symptoms were evaluated over following up included temperature, frequency and, nature of stool, presence and severity of dyspeptic manifestations, nausea, frequency of vomiting, presence and severity of abdominal pain syndrome. Statistical data processing was carried out using statistical analysis Statistica v. 13.0 (StatSoft Inc., USA).

Results. The combined use of L. casei DG and FOS in the pathogenetic therapy of acute intestinal infections reduces the time of relief of clinical manifestations. The severity of abdominal pain syndrome regresses significantly faster when using this synbiotic. Normalization of the frequency and nature of stool occurs significantly faster with the simultaneous appointment of pathogenetic therapy and the synbiotic. The combination of L. casei DG and FOS has demonstrated a high safety profile, side effects have not been reported.

Conclusion. It is advisable to prescribe the combination of L. casei DG and FOS from the first day of acute intestinal infections alongside with pathogenetic and symptomatic therapy to achieve a clinical effect more quickly.

Contribution: Sutovskaya D.V. — concept and design of the study, editing; Sutovskaya D.V., Litvinov D.I. — collection and processing of material, writing the text, approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: November 02, 2023
Accepted: November 28, 2023
Published: December 27, 2023

1. Usenko D.V., Gorelova E.A. Acute intestinal infections of viral etiology in children: prospects for diagnosis and therapy. Meditsinskiy sovet. 2017; (9): 86–92. https://doi.org/10.21518/2079-701X-2017-9-86-92 https://elibrary.ru/zcirjn (in Russian)

2. Xiong L., Li Y., Li J., Yang J., Shang L., He X., et al. Intestinal microbiota profiles in infants with acute gastroenteritis caused by rotavirus and norovirus infection: a prospective cohort study. Int. J. Infect. Dis. 2021; 111: 76–84. https://doi.org/10.1016/j.ijid.2021.08.024

3. Sturgeon J.P., Njunge J.M., Bourke C.D., Gonzales G.B., Robertson R.C., Bwakura-Dangarembizi M., et al. Inflammation: the driver of poor outcomes among children with severe acute malnutrition? Nutr. Rev. 2023; 81(12): 1636–52. https://doi.org/10.1093/nutrit/nuad030

4. Marasco G., Cirota G.G., Rossini B., Lungaro L., Di Biase A.R., Colecchia A., et al. Probiotics, prebiotics and other dietary supplements for gut microbiota modulation in celiac disease patients. Nutrients. 2020; 12(9): 2674. https://doi.org/10.3390/nu12092674

5. Martyniak A., Medyńska-Przęczek A., Wędrychowicz A., Skoczeń S., Tomasik P.J. Prebiotics, probiotics, synbiotics, paraprobiotics and postbiotic compounds in IBD. Biomolecules. 2021; 11(12): 1903. https://doi.org/10.3390/biom11121903

6. Plaza-Díaz J., Ruiz-Ojeda F.J., Gil-Campos M., Gil A. Immune-mediated mechanisms of action of probiotics and synbiotics in treating pediatric intestinal diseases. Nutrients. 2018; 10(1): 42. https://doi.org/10.3390/nu10010042

7. Morgan R.L., Preidis G.A., Kashyap P.C., Weizman A.V., Sadeghirad B. Probiotics reduce mortality and morbidity in preterm, low-birth-weight infants: a systematic review and network meta-analysis of randomized trials. Gastroenterology. 2020; 159(2): 467–80. https://doi.org/10.1053/j.gastro.2020.05.096

8. Nolan L.S., Rimer J.M., Good M. The role of human milk oligosaccharides and probiotics on the neonatal microbiome and risk of necrotizing enterocolitis: a narrative review. Nutrients. 2020; 12(10): 3052. https://doi.org/10.3390/nu12103052

9. Dargenio V.N., Castellaneta S., Panico S., Papagni M.E., Dargenio C., Schettini F., et al. Probiotics and gastrointestinal diseases. Minerva Pediatr. (Torino). 2022; 74(6): 703–23. https://doi.org/10.23736/S2724-5276.22.07031-8

10. Horne R.G., Freedman S.B., Johnson-Henry K.C., Pang X.L., Lee B.E., Farion K.J., et al. Intestinal microbial composition of children in a randomized controlled trial of probiotics to treat acute gastroenteritis. Front. Cell Infect. Microbiol. 2022; 12: 883163. https://doi.org/10.3389/fcimb.2022.883163

11. Radicioni M., Koirala R., Fiore W., Leuratti C., Guglielmetti S., Arioli S. Survival of L. casei DG® (Lactobacillus paracasei CNCMI1572) in the gastrointestinal tract of a healthy paediatric population. Eur. J. Nutr. 2019; 58(8): 3161–70. https://doi.org/10.1007/s00394-018-1860-5

12. Bretto E., D’Amico F., Fiore W., Tursi A., Danese S. Lactobacillus paracasei CNCM I 1572: A promising candidate for management of colonic diverticular disease. J. Clin. Med. 2022; 11(7): 1916. https://doi.org/10.3390/jcm11071916

13. Szopa K., Szajnar K., Pawlos M., Znamirowska-Piotrowska A. Probiotic fermented goat’s and sheep’s milk: effect of type and dose of collagen on survival of four strains of probiotic bacteria during simulated in vitro digestion conditions. Nutrients. 2023; 15(14): 3241. https://doi.org/10.3390/nu15143241

14. Hyoung A., Kim J., Hogarty M.P., Harris V.C., Baldridge M.T. The complex interactions between rotavirus and the gut microbiota. Front. Cell. Infect. Microbiol. 2021: 10: 586751. https://doi.org/10.3389/fcimb.2020.586751.89

15. Liu Y., Tran D.Q., Rhoads J.M. Probiotics in disease prevention and treatment. J. Clin. Pharmacol. 2018; 58(Suppl. 10): 164–79. https://doi.org/10.1002/jcph.1121

16. Cukrowska B., Bierła J.B., Zakrzewska M., Klukowski M., Maciorkowska E. The Relationship between the infant gut microbiota and allergy. The role of Bifidobacterium breve and prebiotic oligosaccharides in the activation of anti-allergic mechanisms in early life. Nutrients. 2020; 12(4): 946. https://doi.org/10.3390/nu12040946

17. Kaufmann B., Seyfried N., Hartmann D., Hartmann P. Probiotics, prebiotics, and synbiotics in nonalcoholic fatty liver disease and alcohol-associated liver disease. Am. J. Physiol. Gastrointest. Liver. Physiol. 2023; 325(1): 42–61. https://doi.org/10.1152/ajpgi.00017.2023

18. Wala S.J., Ragan M.V., Sajankila N., Volpe S.G., Purayil N., Dumbauld Z., et al. Probiotics and novel probiotic delivery systems. Semin. Pediatr. Surg. 2023; 32(3): 151307. https://doi.org/10.1016/j.sempedsurg.2023.151307.10

19. Akutko K., Stawarski A. Probiotics, prebiotics and synbiotics in inflammatory bowel diseases. J. Clin. Med. 2021; 10(11): 2466. https://doi.org/10.3390/jcm10112466

20. Wallace C., Gordon M., Sinopoulou V., Akobeng A.K. Probiotics for management of functional abdominal pain disorders in children. Cochrane Database Syst. Rev. 2023; 2(2): CD012849. https://doi.org/10.1002/14651858.CD012849.pub2