Recommendations for the adjuvant use of the poly-antibiotic–resistant probiotic Bacillus clausii (O/C, SIN, N/R, T) in acute, chronic, and antibiotic-associated diarrhea in children: consensus from Asian experts

• Published in: Tropical Diseases, Travel Medicine and Vaccines
• Main Authors: Jo-Anne De Castro, Dhanasekhar Kesavelu, Keya Rani Lahiri, Nataruks Chaijitraruch, Voranush Chongsrisawat, Pramod Prabhakar Jog, Yun Haw Liaw, Gia Khanh Nguyen, Thi Viet Ha Nguyen, Uday Ananth Pai, Huu Nguyet Diem Phan, Seng Hock Quak, Pornthep Tanpowpong, Mary Jean Guno
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2020
• Subjects: Acute viral diarrhea; Antibiotic-associated diarrhea; Bacillus clausii; Clostridium difficile-associated diarrhea; Chronic diarrhea; Gastroenteritis; Arctic medicine. Tropical medicine; RC955-962; Arctic; Pacific
• Online Access: https://doi.org/10.1186/s40794-020-00120-4; https://doaj.org/article/cd06ad599b944dd4a5c143152eaf50a4

Abstract This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Evidence-based recommendations and randomized controlled trials in the region are included. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by utilizing a modified Delphi process and applying the Likert scale in an electronic voting process. Bacillus clausii was recommended as an adjunct treatment with oral rehydration solution for acute viral diarrhea. B. clausii may also be considered for prevention of antibiotic-associated diarrhea, Clostridium difficile-induced diarrhea, and as adjunct treatment of Helicobacter pylori. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations currently apply to most Asia-Pacific countries. Ideally, these need to be validated with local randomized-controlled trials.