ירחון החברה הישראלית לפדיאטריה אמבולטורית (חיפ"א) גיליון 2019-1

37 Lastly, the course of 5 days may be too short. Probiotics may not be able to overcome an infection during its acute phase (when the trial was performed), but may hasten resolution and restoration of the gut flora (when the trial was measured). If the probiotics were given for a longer duration, say the entire 14 days, would the results have been different? Probiotics have shown benefit is a range of illnesses including NEC, preventing antibiotic-associated diarrhea, preventing Clostridium infections and more. They are recommended in European and our own guidelines. However, in light of these trials, additional studies are needed to further investigate its benefit in treating acute gastroenteritis Bottom line: Probiotics, though safe to use, may not hold as much promise in alleviating symptoms of acute gastroenteritis. However, more investigation is needed to determine any benefit that may be obtained in such illnesses. • Guarino A, Ashkenazi S, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014 Jul;59(1):132-52. DOI: 10.1097/MPG.0000000000000375 • Allen SJ, Martinez EG, et al. Probiotics for treating acute infectious diarrhea. Cochrane Database Syst Rev 2010;11:CD003048. פיראס ר, אשכנזי ש, וכו’, נייר עמדה: המלצות לאבחון ולטיפול בגסטרואנטריטיס חדה בילדים בישראל. נובמבר • , הר”י 2015 https://www.ima.org.il/userfiles/image/clinical_49_gastro.pdf • Freedman SB, et al. Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis. N Engl J Med. 2018 Nov 22;379(21):2015-2026. DOI: 10.1056/NEJMoa1802597 • Schnadower D, et al. Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children. N Engl J Med. 2018 Nov 22;379(21):2002-2014. DOI: 10.1056/NEJMoa1802598