CORRECTION OF DYSBIOTIC ABNORMALITIES IN CHILDREN WITH ACUTE RESPIRATORY DISORDERS

Abstract

Background: A special attention in the treatment of acute respiratory disorders (ARD) in children should be paid to correction of defense mechanisms of the body, including elimination of dysbiotic abnormalities. The use of probiotics, whose mechanism of action is directed to restoration of qualitative and quantitative composition of normal microbiota, is considered to be perspective in the combination therapy of ARD patients. Aim: to assess clinical and laboratory efficacy of probiotic Florin forte in children with ARD. Materials and methods: One hundred and eleven children aged from3 months to 14 years with ARD were included into the study. In 81.1% of cases they had concomitant obstruction of upper respiratory ways. From day1 after admission to the hospital, 81 patients (the main group) were administered probiotic Florin forte as a part of combination therapy for 5 to7 days, and 30 children (the comparator group) were administered the standard treatment without probiotics. Parameters of oropharyngeal and mucosal microflora, immune parameters of anti-infectious resistance (phagocytic activity, phagocytic index, neutrophilic index of digestion), as well as secretory immunoglobulin A levels in saliva were measured during the course of the illness. Results: In the patients of the main group under the combination therapy, there was a significantly more rapid elimination of respiratory symptoms and intoxication (p < 0.05), with shorter duration of hospitalization (4.43 ± 0.19 days vs 6.03 ± 0.25 in the comparator group, p < 0.001). The acute phase of the disease in both groups of patients was characterized by dysbiotic abnormalities in oropharyngeal and gut microbiota, with a decrease in non-specific host resistance parameters. After treatment, there was a significantly higher number of indigenous microbial associations in the main group, compared to that in the comparator group (43.4% vs 16.7%, p < 0.01), and a higher growth of enterobacteria (16.9% vs 33.3%, respectively, p < 0.1). In the patients taking the probiotic, there was a trend towards restoration of qualitative and quantitative composition of the gut microflora: in the main group, there was an increase in proportions of children with a normal counts of bifidobacteria (from 26.4% in the acute phase to45.3% after treatment, p < 0.05) and lactobacilli (from 7.5% to 16.9%, respectively, p < 0.05), and a decrease of proportion of children with hemolytic Escherichia coli (in 32.1% before treatment and in22.6% after treatment, p > 0.05). Improvements of immune parameters of the anti-infectious resistance system were found only in the main group: the phagocytic index at 120 minutes after incubation of neutrophils was 4.26 ± 0.04 before treatment and 3.94 ± 0.09 after treatment (р < 0.05); the neutrophil digestion index, 5.70 ± 0.71 and10.83 ± 0.94 (р < 0.01), and secretory IgA level in saliva, 0.05 ± 0.03 and 0.125 ± 0.03 mcg/mL, respectively (р < 0.05). Conclusion: Inclusion of probiotic Florin forte into combination therapy of ARD patients promoted more rapid clinical recovery, improvement of biocenotic parameters in oropharyngeal and gut mucosa and an increase in anti-infectious resistance of the host.

Keywords

• children
• acute respiratory disorder
• microbiota
• dysbiosis
• oropharynx
• gut
• florin forte