Probiotic Lactobacillus casei Shirota improves efficacy of amoxicillin-sulbactam against childhood fast breathing pneumonia in a randomized placebo-controlled double blind clinical study

• Published in: Journal of Clinical Biochemistry and Nutrition 2018, Vol.63(3), pp.233-237
• Main Authors: Li, Bing, Zheng, Junqing, Zhang, Xia, Hong, Shan
• Format: Article
• Language: English
• Subjects: Amoxicillin; amoxicillin-sulbactam; Antibiotics; Bile; Breathing; Childhood; childhood pneumonia; Children; Double-blind studies; Failure rates; fast breathing pneumonia; Interferon; Lactobacilli; Lactobacillus casei; Lactobacillus casei Shirota; Oral administration; Original; Penicillin; Pneumonia; Probiotics; Respiration; Serum levels; Sulbactam; Tumor necrosis factor-TNF; Tumor necrosis factor-α; Tumors; γ-Interferon
• ISSN: 0912-0009; 1880-5086
• DOI: 10.3164/jcbn.17-117

The aim of the present study was to investigate the efficacy of oral administration of probiotic Lactobacillus casei Shirota and amoxicillin-sulbactam in treating childhood fast breathing pneumonia. 518 children diagnosed of fast breathing pneumonia were enrolled and randomly assigned to be administered either amoxicillin-sulbactam + Lactobacillus casei Shirota or amoxicillin-sulbactam + placebo. Primary outcome was defined as treatment failure before day 3, and secondary outcome was defined as treatment failure during follow-ups on day 6 and 12. Serum levels of tumor necrosis factor-α and interferon-γ were also examined at the end of day 3. Treatment failure rate before day 3 was significantly reduced in amoxicillin-sulbactam + Lactobacillus casei Shirota group compared to amoxicillin-sulbactam + placebo group. Serum levels of tumor necrosis factor-α and interferon-γ were both significantly reduced in amoxicillin-sulbactam + placebo group on day 3. On day 6 and 12, although treatment failure rates were higher than on day 3 in both groups, it was still significantly reduced in amoxicillin-sulbactam + Lactobacillus casei Shirota group. No severe adverse effects were observed in either treatment group. In conclusion, Probiotic Lactobacillus casei Shirota, in combination with amoxicillin-sulbactam, is more effective in treating childhood fast breathing pneumonia, which supports the potential clinical application of Lactobacillus casei Shirota as a safe supplement to amoxicillin-sulbactam therapy against childhood fast breathing pneumonia.