Çocukluk Çağında Probiyotik Kullanımı

Probiyotikler, yeterli miktarda alındığında konakçının bağırsaklarındamikrobiyal dengeyi düzenleyerek sağlığı üzerinde olumlu etkileri olan canlımikroorganizmalardır. Besinlerle veya destek amaçlı alınan probiyotikler; bakteriveya mayalardır. Patojen ve zararlı bakterilerin sayılarını azaltarak, mikrobiyalmetabolizmayı değiştirerek bağışıklık sistemini iyileştirerek etki ederler. Kapsül,tablet, saşe veya toz şeklinde bulunurlar. Akut enfeksiyöz ishallerin önlenmesindesağlıklı bebek ve çocuklarda yapılan randomize kontrollü çalışmalarda ishalinönlemesinde probiyotiklerin ılımlı faydası gösterilmiştir. Çocuklarda akut viralishallerde etkisi iyi ortaya konulmuştur. Probiyotiklerin antibiyotikle ilişkiliishal, irritable bağırsak sendromu, ülseratif kolit, Crohn hastalığı, helicobacterpylori enfeksiyonu kabızlık ekstraintestinal enfeksiyonlar gibi durumlardakietkinliği konusunda daha ileri çalışmalara gereksinim vardır. Atopik hastalıklarda,prematüre bebeklerde nekrotizan enterokolitin önlenmesine dair olumlu sonuçlarvardır. Çocuklarda çeşitli klinik durumlarda etkinliğine dair çalışmalar devametmektedir. (Gün cel Pe di at ri 2014;2:88-94)

Probiotic Use in Childhood

Probiotics are live microorganisms that produce a benefit to host by improvingmicrobial balance in the gut, when provided in adequate amounts from food andsupplements. Probiotics, taken with foods or food supplements are bacteria or yeasts.They act by reducing the number of pathogens and harmful bacteria, by changingmicrobial metabolism and by improving the immune system. They are in capsule,tablet, cachet or powdered form. In randomised controlled trials with probiotics, theprevention of acute infectious diarrhea in healthy infants and children had shownmoderate benefits. The effect of probiotics in acute viral diarrhea is well studied.More research is needed to determine the effect of probiotics in antibiotic associateddiarrhea, irritable bowel syndrome, ulcerative colitis, Crohn s disease, helicobacterpylori infection, constipation and extraintestinal infections. There are positiveresults with probiotics in atopic diseases and preventing necrotising enterocolitis inpremature infants. Studies continue for the effectiveness of the probiotics in variousclinical conditions in children. (The Jo ur nal of Cur rent Pe di at rics 2014;2:88-94)

PDF

___

1. Figueroe-gonzales I, Qijano G,Ramirez G, Cruz-Guerrero A. Probiotics and prebiotics perspectives and challenges. J Sci Food Agric 2011;91:1341-8.
2. Thomas DW, Greer FR. American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition. Probiotics and Prebiotics in Pediatrics. Pediatrics 2010;126:1217-31.
3. Coskun T. Pro-pre- ve simbiyotikler. Turkiye Klinikleri J Pediatr Sci 2007;3:82-98.
4. Coskun T. Probiyotikler, Genel özellikleri ve Etki mekanizmaları. Turkiye Klinikleri J Pediatr Sci 2012;8:1-11.
5. Soccol CR, de Souza Vandenberhe LP, Spier MR, Medeiros ABP, Yamaguishi CT, De Dea Lindner J, et al. The potential of probiotics: a review. Food Technol Biotechnol 2010;48:413-34.
6. Ciorba MA. A gastroenterologist guide to probiotics. Clin Gastroenterol Hepatol 2012;10:960-8.
7. Kau AL, Ahern PP, Grifin NW, Goodman AL, Gordon JI. Human Nutrition, the gut microbiome and immune system. Nature 2011;474:327-36.
8. Macpherson AJ, Harris NL. Interactions between commensal intestinal bacteria and the immune system. Nat Rev Immunol 2004;4:478-85.
9. Arslan N. Normal bağırsak florası beslenme ile ilişkisi. Turkiye Klinikleri J Pediatr Sci 2012;8:12-8.
10. Indrio F, Neu J. The intestinal microbiome of infants and the use of probiotics. Curr opin Pediatr 2011;23:145-50.
11. Çokuğraş FÇ, Beşer ÖF. Mukozal immünite. Turkiye Klinikleri J Pediatr Sci 2012;8:19-26.
12. ESPGHAN Clinical Practice Guideline. Clinical Efficacy of Probiotics: Review of the Evidence With Focus on Children. J Pediatr Gastroenterol Nutr 2006;43:550-57.
13. Yağcı RV. Probiyotikler. Turkiye Klinikleri J Pediatr Sci 2012;8:127-9.
14. Williams NT. Probiotics. Am J Health Syst Pharm 2010;67:449-58.
15. Guandalini S. Probiotics for prevention and treatment of diarrhea. J Clin Gastroenterol 2011;45:149-53.
16. Szajewska H, Kotowska M, Mrukowicz JZ, Armanska M, Mikolajczyk W. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr 2001;138:361-5.
17. Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhea. Cochrane Satabase Syst Rev 2010;10:CD003048.
18. Duman M. Akut ishallerin önlenmesinde ve tedavisinde probiyotikler. Turkiye Klinikleri J Pediatr Sci 2012;8:27-30.
19. Szajewska H, Mrukowicz JZ. Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children: a systematic review of published randomized, double- blind, placebo-controlled trials. J Pediatr Gastroenterol Nutr 2001;33:17-25.
20. Huang JS, Bousvaros A, Lee JW, Diaz A, Davidson EJ. Efficacy of probiotic use in acute diarrhea in children: a meta-analysis. Dig Dis Sci 2002;47:2625-34.
21. Chen CC, Khon MS, Lai MW, Chao HC, Chang KW, Chen SY, et al. Probiotics have clinical, microbiologic and immunologic efficacy in acute infectious diarrhea. Pediatr Infec Dis J 2010;29:135-8.
22. Htwe K, yee Ks, Tin M, Vandenplas Y. Effect of saccaromyces boulardii in the treatment of acute watery diarrhea in Myanmar children: a randomisd control study. Am j Trop Med Hyg 2008;78:214-6.
23. Corrêa NB, Péret Filho LA, Penna FJ, Lima FM, Nicoli JR. A randomized Formula controlled trial of Bifidobacterium lactis and Streptococcus thermophilus for prevention of antibiotic- associated diarrhea in infants. J Clin Gastroenterol 2005;39:385- 9.
24. DSouza AL, Rajkumar C, Cooke J, Bulpitt CJ. Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis. BMJ 2002;324:1361.
25. Johnston BC, Goldenberg JZ, Vandvik PO, Sun X, Guyatt GH. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 2011;CD004827.
26. Uysal P, Uzuner N. Allerjik hastalıklar ve Probiyotikler. Turkiye Klinikleri J Pediatr Sci 2012;8:57-66.
27. Weston S, Halbert A, Richmond P, Prescott SL. Effects of probiotics on atopic dermatitis: a randomised controlled trial. Arch Dis Child 2005;90:892-7.
28. Osborn DA, Sinn JK. Probiotics in infants for prevention of allergic disease and food hypersensitivity. Cochrane Database Syst Rev 2007;CD006135.
29. Boyle RJ, Bath-Hextall FJ, Leonardi-Bee J, Murrell DF, Tang ML. Probiotics for treating eczema. Cochrane Database Syst Rev 2008;CD006135.
30. Sever AH, Duman N. Yenidoğanlarda probiyotik kullanımı. Turkiye Klinikleri J Pediatr Sci 2012;8:74-80.
31. Alfaleh K, Bassler D. Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev 2008;CD005496.
32. Lesbros-Pantoflickova D, Corthesy-Theulaz I, Blum AL. Helicobacter pylori and probiotics. J Nutr 2007;137:812-18.
33. Sıkora J, Valeckova K, Amlerova J, Siala K, Dedek P, Watkins S, et al. Effects of a specially designed fermented milk product containing probiotic Lactobacillus casei DN-114 001 and the eradication of H. pylori in children: a prospective randomized double-blind study. J Clin Gastroenterol 2005;39:692-8.
34. Demirören K, Özen H. İnflamatuar Bağırsak Hastalıklarının Tedavisinde Probiyotikler. Turkiye Klinikleri J Pediatr Sci 2012;8:34-42.
35. Mallon P, McKay D, Kirk S, Gardiner K. Probiotics for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2007;CD005573.
36. Miele E, Pascarella F, Giannetti E, Quaglietta L, Baldassano RN, Staiano A. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol 2009;104:437-43.
37. Bousvaros A, Guandalini S, Baldassano RN, Botelho C, Evans J, Ferry GD, et al. A randomized, double-blind trial of Lactobacillus GG versus placebo in addition to standard maintenance therapy for children with Crohns disease. Inflamm Bowel Dis 2005;11:833-9.
38. Rolfe VE, Fortun PJ, Hawkey CJ, Bath-Hextall F. Probiotics for maintenance of remission in Crohns disease. Cochrane Database Syst Rev 2006;CD004826.
39. Bausserman M, Michail S. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. J Pediatr 2005;147:197-201.
40. Aksu AU, Dalgıc B. İrritabl Bağırsak hastalığı ve probiyotikler. Turkiye Klinikleri J Pediatr Sci 2012;8:43-7.
41. Banaszkiewicz A, Szajewska H. Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constipation in children: a double-blind, placebo controlled randomized trial. J Pediatr 2005;146:364-9.
42. Chmielewska A, Szajewska H. Systematic review of randomised controlled trials: probiotics for functional constipation. World J Gastroenterol 2010;16:69-75.
43. Kasırga E. Konstipasyonun önlenmesi ve tedavisinde probiyotikler. Turkiye Klinikleri J Pediatr Sci 2012;8:53-6.
44. Savino F, Pelle E, Palumeri E, Oggero R, Miniero R. Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospecive randomised study. Pediatrics 2007;119:124-30.
45. Savino F, Cordisco L, Tarasco V, Palumeri E, Calabrese R, Oggrero R, et al. Lactobacillus reuteri DSM 17938 in infantile colic: a randomised, double-blind,plasebo-controlled trial. Pediatrics 2010;126:526-33.
46. Hatakka K, Savilahti E, Ponka A, Meurman JH, Poussa T, Näse L, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ 2001;322:1327.
47. Kara A. Probiyotiklerin enfeksiyon hastalıklarında kullanımı. Turkiye Klinikleri J Pediatr Sci 2012;8:67-73.
48. Arslan N. Obezite ve probiyotikler. Turkiye Klinikleri J Pediatr Sci 2012;8:102-9.
49. Dinleyici EÇ. Probiyotik kullanımının güvenilirliği. Turkiye Klinikleri J Pediatr Sci 2012;8:110-4.
50. Wallace B. Clinical use of probiotics in the pediatric population. Nutr Clin Pract 2009:7:50-9.
51. Land MH, Rouster-Stevens K, Woods CR, Cannon ML, Cnota J, Shetty AK. Lactobacillus sepsis associated with probiotic therapy. Pediatrics 2005;115:178-81.
52. Kunz AN, Noel JM, Fairchok MP. Two cases of Lactobacillus bacteremia during probiotic treatment of short gut syndrome. J Pediatr Gastroenterol Nutr 2004;38:457-8.
53. Saavedra JM, Abi-Hanna A, Moore N, Yolken RH. Long- term consumption of infant formulas containing live probiotic bacteria: tolerance and safety. Am J Clin Nutr 2004;79:261-7.