Colombian Guideline for the Use of Probiotics in Pediatric Diseases

Abstract

Introduction. In the last 25 years the use of probiotics has undergone an important metamorphosis thanks to “omics” science, which has generated a prolific scientific information and, consequently, an increase in clinical use. Probiotics are defined as "live microorganisms that, when administered in adequate quantities, confer health benefits on the host". The relationship between the intestinal microbiota and the state of health of people is proven every day, therefore, it is important to analyze from the scientific evidence which probiotics are useful in certain pediatric pathologies. Objective. To provide the medical community an exhaustive analysis of the use of probiotics and to establish recommendations for he pediatric population. Material and Methods. This guide was developed by a multidisciplinary team with the support of the Colombian Association of Probiotics and Prebiotics and the Colombian College of Pediatric Gastroenterology, Hepatology and Nutrition. Working groups were formed to select questions of clinical interest, systematically search systematic reviews, meta-analysis, and extract information and recommendations for each question. Epidemiology experts performed the systematic literature search. Tables of evidence and recommendations were made based on the Grading of Recommendations Assessment, Development and Evaluation methodology. The recommendations in the guideline were assessed at an expert meeting and assigned a grade of recommendation. Results and conclusions. Ten questions related to the most common pediatric pathologies were pro-posed for the use of probiotics. In conclusion, the group of experts made recommendations in the following diseases: necrotizing enterocolitis in premature infants, infant colic, acute diarrhea, diarrhea secondary to tantibiotic use, incidence of respiratory infections, incidence of allergies, functional abdominal pain, cow's milk protein allergy, inflammatory bowel disease, and small intestinal bacterial overgrowth. The strains with the higlest quality of evidence in our guidelines were, in no order of importance: Saccharomyces boulardii strain CNCM I-745, Limosilactobacillus reuteri strain DSM 17938, Lacticaseibacillus rhamno-sus GG, Lactobacillus reuteri strain DSM 17938.