Meta-analysis of the effects of Bifidobacterium preparations for the prevention and treatment of pediatric antibiotic-associated diarrhea in China

- Several trials have suggested that Bifidobacterium preparations has efficacy in the prevention and treatment of pediatric antibiotic-associated diarrhea in China.
- The present meta-analysis indicated Bifidobacterium preparations might be efficacious for the prevention and treatment of pediatric antibiotic-associated diarrhea in China.
- More rigorous controlled trials are required to substantiate or refute these early findings because of the poor quality of the included trials.

Bifidobacterium preparations are increasingly used for pediatric antibiotic-associated diarrhea (AAD) in China. The aim of this study was to review existing evidence on the efficacy of Bifidobacterium preparations for the prevention and treatment of pediatric AAD in China. Searches were performed with Medline, Embase, Cochrane Central Register of Controlled Trials, CNKI, and CBM databases. Thirty trials met the inclusion criteria. Of the 30 trials, five Bifidobacterium preparations were included. The preparations were all Bifidobacterium based, in combined with Lactobacillus, Enterococcus, Bacillus, Streptococcus or Clostridium strains. The pooled results of the 30 trials, which included 7225 participants, indicated a statistically significant association of Bifidobacterium preparations administration with reduction in pediatric AAD (odds ratio [OR], 0.33; 95% confidence interval [CI], 0.29-0.39; P < 0.01). When the meta-analysis was re-performed according to the trials explicitly aiming to prevent or treat pediatric AAD, respectively, the pooled results were similar (Bifidobacterium preparations use for preventing pediatric AAD (n = 21): pooled OR, 0.34, 95% CI, 0.28-0.41, P < 0.01; Bifidobacterium preparations use for treating pediatric AAD (n = 9): pooled OR, 0.32, 95% CI, 0.23-0.43, P < 0.01). Subgroup analyses which based on Bifidobacterium preparations variety, clinical condition, or participant's age also showed statistically significant benefit of adjunct Bifidobacterium preparations for the prevention and treatment of pediatric AAD in China. The pooled evidence suggested that Bifidobacterium preparations might be efficacious for the prevention and treatment of pediatric AAD in China.