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

Jo Anne De CastroDhanasekhar KesaveluKeya Rani LahiriNataruks ChaijitraruchVoranush ChongsrisawatPramod Prabhakar JogYun Haw LiawGia Khanh NguyenThi Viet Ha NguyenUday Ananth PaiHuu Nguyet Diem PhanSeng Hock QuakPornthep TanpowpongMary Jean GunoDe La Salle Medical and Health Sciences InstituteDr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, PuneUniversity of Medicine and Pharmacy VietnamHanoi Medical UniversityNational University Hospital, SingaporeKing Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn UniversityFaculty of Medicine, Ramathibodi Hospital, Mahidol UniversityDr. D.Y. Patil Medical College, Navi MumbaiInstitute of PediatricsPai’s ClinicKPJ Sabah Specialist HospitalApollo Children's HospitalVietnam Aerospace Association2020-11-182020-11-182020-12-01Tropical Diseases, Travel Medicine and Vaccines. Vol.6, No.1 (2020)205509362-s2.0-85093985511https://repository.li.mahidol.ac.th/handle/20.500.14594/60024© 2020, The Author(s). 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.Mahidol UniversityMedicineRecommendations 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 expertsReviewSCOPUS10.1186/s40794-020-00120-4