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| Analysis on the outpatient and emergency prescriptions of probiotics for the treatment of functional dyspepsia in children |
| YU Yuncui1▲ DU Saifei2▲ ZHANG Li3 WEI Ting2 JIA Lulu1 MA Jinjing4 JIN Yan2 WANG Xiaoling4 |
1.Clinical Research Center, National Center for Children′s Health Beijing Children′s Hospital, Capital Medical University, Beijing 100045, China;
2.Department of Clinical Pharmacology, Harbin Children′s Hospital, Heilongjiang Province, Harbin 150010, China;
3.Department of Gastroenterology, Harbin Children′s Hospital, Heilongjiang Province, Harbin 150010, China;
4.Department of Pharmacy, National Center for Children′s Health Beijing Children′s Hospital, Capital Medical University, Beijing 100045, China |
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Abstract Objective To understand the current status and problems of the clinical application of microecological preparations in the treatment of children with functional dyspepsia (FD) in China, and to provide the basis for the rational application of microecological preparations in the treatment of children with FD. Methods A retrospective selection of five Grade A children′s hospitals across the country (Beijing Children′s Hospital of Capital Medical University, Harbin Children′s Hospital, He′nan Children′s Hospital, Hu′nan Children′s Hospital, Jiangxi Provincial Children′s Hospital) would use microecological preparations to treat children from January to March 2019, while all outpatient/emergency prescriptions for FD were extracted. At the same time, the relevant guidelines/consensus of probiotics and FD at home and abroad were sorted out, and the treatment of children with FD by probiotics were investigated and analyzed. Results A total of 14 099 FD prescriptions for the treatment of children with microecological preparations were drawn, of which 56.43% were males (7956/14 099) and females accounted for 43.57% (6143/14 099). The proportion of children aged one to three years was the highest, reaching 28.58%. A total of 17 kinds of microecological preparations were involved in the prescriptions. Among them, the prescription number of Clostridium Butyricum Duojun San was the highest, reaching 64.65% (9115/14 099). The proportion of prescriptions with combined drugs accounted for 59.69% (8415/14 099). The combined drugs mainly included Chinese patent medicines for strengthening the spleen and eliminating food, Chinese patent medicines for clearing away heat and detoxification, and antibacterial drugs. The incidence of off-label medication prescriptions was 27.68% (3903/14 099), and there were mainly cases of over-indications, over-population, over-usage and dosage. A total of 15 domestic and foreign microecological preparations and FD-related clinical guidelines/consensus have been sorted out. In terms of effectiveness, only two domestic expert consensus suggested that probiotics can be used as adjuvant drugs for the treatment of FD. The recommended varieties mainly include double Fidobacterium, Lactobacillus, etc. In terms of safety, the seven guidelines and consensus mention and generally affirm the safety of probiotics, however none of them separately mentions the safety of probiotics in treating children with FD. Conclusion The application of microecological preparations to treat children with FD is common clinically, but there are still cases of off-label use of drugs, and there is little evidence-based medicine. Clinicians should standardize their prescription behavior. At the same time, a large number of multi-center prospective studies based on pediatric groups are still needed in the future to provide more support for the rational application of probiotics in the treatment of children with FD.
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