Frequency of Antibiotic-Associated Diarrhea and Related Complications in Pediatric Patients Who Underwent Hypospadias Repair: a Comparative Study Using Probiotics vs Placebo
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This study aimed to evaluate the effectiveness of probiotics (Lactobacillus rhamnosus GG), as a preventive measure of antibiotic-associated diarrhea (AAD) in children who underwent hypospadias repair and its clinical consequences on postoperative outcome, comparing the group treated with probiotics + antibiotics with two control groups (only antibiotics and antibiotics + placebo). We performed a prospective, randomized, placebo-controlled study with three groups of patients (30 boys for each group) who underwent hypospadias repair in our unit from March 2016 to December 2016. G1 received antibiotics + probiotics (L. rhamnosus GG), while G2 and G3 respectively received only antibiotics or antibiotics + placebo (glucose solution at 5%) for the same period. The patients were evaluated in regard to the number of evacuations/day, stool consistency, and the number of dressings/day. The overall incidence of postoperative AAD was 33.3% (30/90), and it was statistically lower in G1 patients compared to G2 and G3 ones (p = 0.002). The duration of AAD was significantly longer in G2 and G3 compared to G1 (p = 0.001). In G1, the frequency of dressing change was significantly lower compared to G2 and G3 (p = 0.001).The incidence of postoperative complications (fistula and dehiscence) was significantly higher in G2 and G3 compared to G1 (p = 0.001). Our study confirmed that the use of probiotic L. rhamnosus GG associated with antibiotics significantly reduced the incidence and the duration of postoperative AAD. In addition, the use of probiotics LGG reduced the frequency of dressing changes and the incidence of postoperative complications, such as urethral fistula and foreskin dehiscence.
KeywordsProbiotics Diarrhea Children Antibiotics Placebo Hypospadias
Compliance with Ethical Standards
All procedures followed were in accordance with the ethical standards of the institutional and national research committee and with the Helsinki Declaration of 1975, as revised in 2008.
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
- 2.Turck D, Bernet JP, Marx J, Kempf H, Giard P, Walbaum O, Lacombe A, Rembert F, Toursel F, Bernasconi P, Gottrand F, McFarland LV, Bloch K (2003) Incidence and risk factors of oral antibiotic-associated diarrhea in an outpatient pediatric population. J Pediatr Gastroenterol Nutr 37(1):22–26CrossRefPubMedGoogle Scholar
- 15.Naber KG, Bergman B, Bishop MC, Bjerklund-Johansen TE, Botto H, Lobel B, Jinenez Cruz F, Selvaggi FP, Urinary Tract Infection (UTI) Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU) (2001) EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI) Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU). Eur Urol 40(5):576–588CrossRefPubMedGoogle Scholar
- 16.Kanamaru S, Terai A, Ishitoya S, Kunishima Y, Nishiyama H, Segawa T, Nakamura E, Kinoshita H, Moroi S, Ito N, Kamoto T, Okuno H, Habuchi T, Senda K, Ichiyama S, Ogawa O, Yamamoto S (2004) Assessment of a protocol for prophylactic antibiotics to prevent perioperative infection in urological surgery: a preliminary study. Int J Urol 11(6):355–363CrossRefPubMedGoogle Scholar
- 18.Yan F, Polk DB (2012) Lactobacillus rhamnosus GG: an updated strategy to use microbial products to promote health. Funct Foods Rev 4(2):77–84Google Scholar
- 23.Esposito C, Savanelli A, Escolino M, Giurin I, Iaquinto M, Alicchio F, Roberti A, Settimi A (2014) Preputioplasty associated with urethroplasty for correction of distal hypospadias: a prospective study and proposition of a new objective scoring system for evaluation of esthetic and functional outcome. J Pediatr Urol 10(2):294–299CrossRefPubMedGoogle Scholar
- 24.Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC (2015) Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 12:CD004827Google Scholar
- 25.Johnston BC, Goldenberg JZ, Vandvik PO, Sun X, Guyatt GH (2011) Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 11:CD004827Google Scholar