Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis

被引：157

作者：

Sung, Valerie ^{[1
,2
]}

D'Amico, Frank ^{[3
,4
]}

Cabana, Michael D. ^{[5
]}

Chau, Kim ^{[6
,7
]}

Koren, Gideon ^{[6
,7
]}

Savino, Francesco ^{[8
]}

Szajewska, Hania ^{[9
]}

Deshpande, Girish ^{[10
,11
]}

Dupont, Christophe ^{[12
,13
]}

Indrio, Flavia ^{[14
]}

Mentula, Silja ^{[15
]}

Partty, Anna ^{[16
]}

Tancredi, Daniel ^{[17
]}

机构：

[1] Royal Childrens Hosp, Murdoch Childrens Res Inst, Melbourne, Vic, Australia

[2] Univ Melbourne, Melbourne, Vic, Australia

[3] Duquesne Univ, Dept Math, Pittsburgh, PA 15219 USA

[4] Univ Pittsburgh, Med Ctr, St Margarets Hosp, Pittsburgh, PA USA

[5] Univ Calif San Francisco, Sch Med, Dept Pediat Epidemiol & Biostat, San Francisco, CA USA

[6] Univ Toronto, Toronto, ON, Canada

[7] Hosp Sick Children, Toronto, ON, Canada

[8] Osped Infantile Regina Margherita, Citta Salute & Sci Torino, Turin, Italy

[9] Med Univ Warsaw, Dept Paediat, Warsaw, Poland

[10] Univ Sydney, Nepean Hosp, Dept Neonatol, Sydney, NSW, Australia

[11] Univ Sydney, Sydney Med Sch Nepean, Sydney, NSW, Australia

[12] Paris Descartes Univ, Dept Pediat Gastroenterol, Paris, France

[13] Necker Enfants Malad Hosp, Paris, France

[14] Univ Bari, Dept Pediat, Bari, Italy

[15] Natl Inst Hlth & Welf, Bacteriol Unit, Helsinki, Finland

[16] Turku Univ Hosp, Dept Pediat & Adolescent Med, Turku, Finland

[17] Univ Calif Davis Hlth Syst, Dept Pediat, Sacramento, CA USA

来源：

PEDIATRICS | 2018年 / 141卷 / 01期

基金：

英国医学研究理事会;

关键词：

BREAST-FED INFANTS; PLACEBO-CONTROLLED TRIAL; AGE-RELATED INCIDENCE; DOUBLE-BLIND; DSM; 17938; MOLECULAR-IDENTIFICATION; INTESTINAL MICROFLORA; PROBIOTICS; DEPRESSION; MANAGEMENT;

D O I：

10.1542/peds.2017-1811

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

CONTEXT: Lactobacillus reuteri DSM17938 has shown promise in managing colic, but conflicting study results have prevented a consensus on whether it is truly effective. OBJECTIVE: Through an individual participant data meta-analysis, we sought to definitively determine if L reuteri DSM17938 effectively reduces crying and/or fussing time in infants with colic and whether effects vary by feeding type. DATA SOURCES: We searched online databases (PubMed, Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, the Database of Abstracts of Reviews of Effects, and Cochrane), e-abstracts, and clinical trial registries. STUDY SELECTION: These were double-blind randomized controlled trials (published by June 2017) of L reuteri DSM17398 versus a placebo, delivered orally to infants with colic, with outcomes of infant crying and/or fussing duration and treatment success at 21 days. DATA EXTRACTION: We collected individual participant raw data from included studies modeled simultaneously in multilevel generalized linear mixed-effects regression models. RESULTS: Four double-blind trials involving 345 infants with colic (174 probiotic and 171 placebo) were included. The probiotic group averaged less crying and/or fussing time than the placebo group at all time points (day 21 adjusted mean difference in change from baseline [minutes] -25.4 [95% confidence interval (CI): -47.3 to -3.5]). The probiotic group was almost twice as likely as the placebo group to experience treatment success at all time points (day 21 adjusted incidence ratio 1.7 [95% CI: 1.4 to 2.2]). Intervention effects were dramatic in breastfed infants (number needed to treat for day 21 success 2.6 [95% CI: 2.0 to 3.6]) but were insignificant in formula-fed infants. LIMITATIONS: There were insufficient data to make conclusions for formula-fed infants with colic. CONCLUSIONS: L reuteri DSM17938 is effective and can be recommended for breastfed infants with colic. Its role in formula-fed infants with colic needs further research.

引用

页数：10

共 47 条

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