摘要
Abstract
Objective To investigate the synergistic preventive effect of Saccharomyces boulardii combined with Bifidobacterium quadruple viable preparation(BQP)on antibiotic-associated diarrhea(AAD)in infants and young children,aiming to provide evidence for optimizing probiotic intervention strategies in clinical practice.Methods A prospective,randomized,parallel controlled trial enrolled hospitalized children aged 1-36 months requiring antibiotic treatment from October 2023 to June 2025.Participants were randomly assigned to four groups:control(no probiotic;n=59),Saccharomyces boulardii(Saccharomyces boulardii powder;n=59),BQP(BQP tablets;n=58),and combined group(Saccharomyces boulardii powder plus BQP tablets;n=60).Probiotic interventions were administered from antibiotic initiation until 7 days after discontinuation.The primary outcome was the incidence of AAD during treatment.Secondary outcomes included diarrhea duration,fecal microbiota composition(16S rRNA sequencing),inflammatory markers(fecal calprotectin,serum interleukin-6),and safety.Follow-up continued until 30 days after probiotic cessation.Results The combined group showed a significantly lower AAD incidence(7%)compared to the Saccharomyces boulardii group(15%),BQP group(17%),and control group(31%)(P<0.0083).On the 30th day after probiotic cessation,the combined group demonstrated a significantly higher Shannon diversity index than the other three groups(P<0.05);relative abundances of Bifidobacterium and Lactobacillus in feces were significantly higher in the combined group than the other three groups(P<0.05),while the relative abundances of Enterococcus were significantly lower than in the other three groups(P<0.05).On the 7th day after antibiotic cessation,the combined group showed significantly lower levels of inflammatory markers compared to the other three groups(P<0.05).Adverse event rates did not differ significantly among groups(P>0.05).Conclusions The combination of Saccharomyces boulardii and BQP prevents AAD in infants and young children more effectively than a single probiotic regimen,potentially through synergistic enhancement of beneficial bacterial colonization and accelerated gut microbiota restoration.This combined probiotic regimen warrants clinical promotion.关键词
抗生素相关性腹泻/布拉氏酵母菌/双歧杆菌四联活菌/肠道微生态/随机对照试验/婴幼儿Key words
Antibiotic-associated diarrhea/Saccharomyces boulardii/Bifidobacterium quadruple viable preparation/Gut microecology/Randomized controlled trial/Infant and young child
