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Acta Paediatr. 2018 Jun;107(6):927-937. doi: 10.1111/apa.14270. Epub 2018 Apr 16.

Guidance on the use of probiotics in clinical practice in children with selected clinical conditions and in specific vulnerable groups.

Author information

1
Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
2
School of Medicine, University J.J Strossmayer, Osijek, Croatia.
3
Paediatric Department, Vittore Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy.
4
2nd Paediatric Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania.
5
Department of Paediatric Gastroenterology, Hepatology and Nutrition, Intestinal Failure Rehabilitation Centre, National Reference Centre for Rare Digestive Diseases, APHP Necker-Enfants Malades Hospital, Paris-Descartes University, Paris, France.
6
Paediatric Gastroenterology, Hepatology and Nutrition, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
7
Department of Paediatrics, Scientific Institute 'Casa Sollievo della Sofferenza', University of Foggia, Foggia, Italy.
8
European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany.

Abstract

AIM:

The use of probiotics has been covered by many guidelines, position papers and evidence-based recommendations, but few have referred to specific patient groups or clinical indications. This review summarises recommendations and scientifically credited guidelines on the use of probiotics for children with selected clinical conditions and provides practice points.

METHODS:

An expert panel was convened by the European Paediatric Association in June 2017 to define the relevant clinical questions for using probiotics in paediatric health care and review and summarise the guidelines, recommendations, position papers and high-quality evidence.

RESULTS:

The panel found that specific probiotic strains were effective in preventing antibiotic-associated and nosocomial diarrhoea, treating acute gastroenteritis and treating infantile colic in breastfed infants. However, special caution is indicated for premature infants, immunocompromised and critically ill patients and those with central venous catheters, cardiac valvular disease and short-gut syndrome. This review discusses the safety of using probiotics in selected groups of paediatric patients and the quality of the available products providing practice points based on proved findings.

CONCLUSION:

Efficacy of probiotics is strain specific. Their benefits are currently scientifically proven for their use in selected clinical conditions in children and not recommended for certain patient groups.

KEYWORDS:

Bifidobacterium; Children; Lactobacillus; Probiotics; Saccharomyces

PMID:
29446865
PMCID:
PMC5969308
DOI:
10.1111/apa.14270
[Indexed for MEDLINE]
Free PMC Article

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