背景:抗生素改变微生物平衡通常导致抗生素相关性腹泻(AAD)。益生菌可以通过提供肠道屏障和恢复肠道菌群来预防和治疗AAD。本研究将概述益生菌预防和治疗儿童AAD的系统评价(SRs)。它还将评估报告,方法论,和纳入SRs的证据质量,为其临床实践提供证据。方法:搜索PubMed后,Embase,科克伦图书馆,CNKI,CBM,VIP,和万方数据数据库,最后纳入益生菌SRs对儿童AAD的预防和治疗,于2022年10月1日前发布。报告,方法论,包括SR的证据质量由PRISMA2020声明评估,AMSTAR2工具,和等级制度。结果:共纳入20个SR,PRISMA2020的结果显示,20个SR中有4个报告相对完整,以及其他一些报告缺陷,得分从17分到26.5分;AMSTAR2的结果表明,3个SR属于中等质量水平,10个SR属于低质量水平,7个SR属于极低质量水平;分级系统的结果显示,所包括的SR共报告了47个结果,三是高水平的证据质量,16个是中等水平的证据质量,24人证据质量低,4例证据质量极低水平;Meta分析结果显示,高剂量(每天5-40亿CFU)益生菌对预防AAD有显著作用,但现在就断定其他益生菌药物对儿童AAD的有效性和安全性还为时过早,除了鼠李糖乳杆菌和布拉氏酵母菌。结论:现有证据表明益生菌有效预防和治疗儿童AAD,益生菌对小儿AAD的影响可能是一种潜在的剂量-反应效应。然而,由于方法上的不足,应谨慎对待结论,reporting,以及纳入SRs的证据质量。因此,方法论,reporting,相关SR的证据质量仍需进一步提高。系统审查注册:https://www。crd.约克。AC.英国/普华永道/,标识符CRD42022362328。
Background: Antibiotics alter the microbial balance commonly resulting in antibiotic-associated diarrhea (AAD). Probiotics may prevent and treat AAD by providing the gut barrier and restoring the gut microflora. This study will overview the Systematic Reviews (SRs) of probiotics in preventing and treating AAD in children. It will also assess the reporting, methodological, and evidence quality of the included SRs to provide evidence for their clinical practice. Methods: After searching PubMed, Embase, Cochrane Library, CNKI, CBM, VIP, and WanFang Data databases, and finally included SRs of probiotics in the prevention and treatment of AAD in children, which were published before 1 October 2022. The reporting, methodological, and evidence quality of the included SRs were assessed by PRISMA 2020 statement, AMSTAR 2 tool, and GRADE system. Results: A total of 20 SRs were included, and the results of PRISMA 2020 showed that 4 out of 20 SRs with relatively complete reporting, and the others within some reporting deficiencies, with scores ranging from 17 points to 26.5 points; the results of AMSTAR 2 showed that 3 SRs belonged to moderate quality level, 10 SRs belonged to low-quality level and 7 SRs being extremely low-quality level; the results of the GRADE system showed that a total of 47 outcomes were reported for the included SRs, three were high-level evidence quality, 16 were medium-level evidence quality, 24 were low-level evidence quality, and four were extremely low-level evidence quality; the results of the Meta-analysis showed that high doses (5-40 billion CFUs per day) of probiotics had a significant effect in the prevention of AAD, but it is too early to conclude the effectiveness and safety of other probiotic drugs for AAD in children, except for Lacticaseibacillus rhamnosus and Saccharomyces boulardii. Conclusion: Current evidence shows that probiotics effectively prevent and treat AAD in children, and the effect of probiotics on pediatric AAD may be a potential dose-response effect. However, the conclusion should be treated with caution due to deficiencies in the methodological, reporting, and evidence quality of the included SRs. Therefore, the methodological, reporting, and evidence quality of relevant SRs still need further improvement. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022362328.