The topicality: the Acute Intestinal Infections (AII) occupy one of the leading places in infectious pathology of children of early age. Today therapy of AII represents a current problem. [1] In modern practice of the pediatrician the huge amount of various medicines exerting beneficial effect on normalization of intestinal microflora at children is applied. One of similar drugs - a probiotics which obligatory component are pro-biotic bacteria - live microorganisms at which use there is a restoration intestine normoflor to the subsequent stabilization of all organism. Pro-biotic bacteria exert positive impact on physiological, immunologic and biochemical functions of an organism. [2]
The purpose: to survey expediency use of probiotics for children at acute intestinal infections.
Materials and methods: studying of references on a problem of acute intestinal infections in domestic and foreign literature, including national leaders and references, and also the analysis of the obtained information.
The results: The range of effects of probiotics on vital activity of a human body includes rising of colonaised resistance to pathogenic and opportunistic microorganisms, a regulation of local immunity, depression of permeability of a mucosa of an intestine and also production of SIgA. Pro-biotic microorganisms compete with a pathogenic microflora for nutrients and the websites of adhesion, and have ability to neutralization of enterotoxins of some pathogenic microorganisms. Besides, pro-biotic microorganisms promote a proliferation of T-killers, increase production of interferon and a mucin.
Intestinal microflora of the newborn - optimum medium for pro-biotic correction. Primary colonization by microorganisms of not congenital happens in the course of passing on patrimonial ways. There are factors breaking normal microbial colonization to them belong: antibacterial therapy of mother and child, manipulation on obstetric aid, artificial nutrition. At premature children in view of a dismaturity of organs of digestive tract, an insufficient exposition of a maternal microflora, the increased risk of contamination by a hospital microflora the risk of development of a disbioz sharply increases.
Purpose of probiotics to premature children can make salutary impact on intestinal microflora formation process. The efficiency of probiotics in therapy of a necrotizing coloenteritis, sepsis, various intrahospitals forms is proved to an infection. Purpose of probiotics is also rational at autoimmune diseases, an allergy, an atopy. [3]
Probiotics occupies one of key places in therapy of OKA children. The combination of peroral rehydration, enterosorbents and pro-biotic drugs is justified clinically and most rationally and expediently at therapy of a gastroenteritis of a virus etiology.
The group of authors conducted the research proving efficiency of this type of therapy. The comparative research of efficiency of dosage forms of monostrainy and polistrainy probiotics in which 219 children aged from 6 months up to 14 months sick with a rotavirus and norovirus gastroenteritis participated showed that use of polistrainy probiotics is most justified as faster dynamics of stopping of a diarrhea was observed, development of eksikoz was less often observed. As therapy of patients the medicinal preparation of Lineks was used.
The group of foreign authors confirmed advantages of use of drugs on the basis of strains of Lactobacillus rhamnosus strain GG (LGG) at therapy of a rotavirus infection and an acute gastroenteritis. The made researches proved efficiency of use of LGG when which using decrease of duration of a diarrhea at children was observed. [4]
However, despite a set of the conducted researches, accurate references in the use duration, a dosage of probiotics, it will hardly be possible to meet in one of the guides to treatment of acute diarrheas. It is bound to such effect of probiotics as a straining addiction, that is there is a need for confirmation of efficiency of use of each of strains for separate clinical tests. Extrapolation of the results received at use of one type of pro-biotic drugs on another is impossible. The researches which proved efficiency of a certain strain of microorganisms in one dose aren't the proof of efficiency of the same drug in other dose.
Conclusions: According to information provided today, experts of ESPGHAN/ESPID formulated the provisions concerning use of probiotics in therapy acute virus diarrheas at children: all pro-biotic drugs have statistical effect and moderate clinical advantage in treatment of acute diarrheas; effects of probiotics at an acute diarrhea at children moderate, straining addiction and dose-dependent. More obvious effect at children in the developed countries at early stages of a pathogenesis of a disease becomes perceptible. The world organization of gastroenterologists (WGO) recommends to discuss with parents an issue of purpose of probiotics to children with diseases of organs of digestive tract, considering the therapy cost, correctness and safety of treatment. [5].
References
- Ostrye kishechnye infekcii u detei: metod. ukaz. dlya studentov V-Vl cursov i vrachei-internov / sost. S.V. Kuznetsov, O.N. Olkhovskaya, T.A. Kirsanov, T.S. Zharkov. - Kharkov: HNMU, 2014. - 24 pages.
- L.N. Mazankova, O.V. Rybalchenko, E.A. Korniyenko, S.G. Perlovskaya. Probiotiki v pediatrii: za i protiv s pozicii docazatelnoj mediciny. Rossijskij vestnik perinatologii i pediatrii, 1, 2016: Page 16-26.
- I.V. Nikolaeva, L.A. Kupchikhina. Probiotiki u novorozhdennyh i detej grudnogo vozrasta (obzor literatury). Vestnik sovremennoy klinicheskoy mediciny. 2013. T. 6, vyp 3. Page 48 — 53.
- D.V. Usenko, A.A. Ploskireva, A.V. Gorelov. Ostrye kishechnye infekcii u detej v practice pediatra: vozmozhnosti diagnostiki i terapii. Voprosy sovremennoj pediatrii. 2014; 13 (3): 12-20.
- S.V. Haliullina, V.A. Anokhin. Terapija ostryh kishechnyh infekcij u detei. Dokazannaya effectivnost (obzor literatury). Zhurnal infektologii. Tom 5, No. 4, 2013, p. 5-13.