Probiotik sebagai Pencegahan Reinfeksi Pasien dengan Antibiotic Associated Diarrhea - Muhammad Sobri Maulana (PT Kalbe Farma Tbk., 2020)
Latar Belakang: Diare akut sering ditemukan dalam praktik klinis sehari-hari. Probiotik diketahui dapat meningkatkan imunitas lokal dan mempercepat waktu penyembuhan diare. Saat ini belum ada pedoman terkait pemberian probiotik sebagai pencegahan reinfeksi C. difficile pada pasien dewasa dengan Antibiotic Associated Diarrhea. Tujuan: Mengetahui efektivitas probiotik dalam mencegah reinfeksi Clostridium difficile. Metode: Penelurusan literatur dari database PubMed, Clinical Key, Science Direct, dan Proquest. Telaah kritis menggunakan appraisal sheet untuk systematic review dari Oxford Center for Evidence Based Medicine tahun 2011. Hasil: Didapatkan 2 studi meta-analisis dengan validitas baik. Goldenberg, et al, menunjukkan penggunaan probiotik dalam mencegah infeksi C. difficile dengan RR 0,62 (95% CI 0,30–0,52) dengan NNT 22. Shen, et al, mendapatkan RR 0,42 (95% CI: 0,3-0,5; p < 0,001) dengan NNT 1,757. Simpulan: Probiotik berpotensi mencegah reinfeksi Clostridium difficile. Background: Acute diarrhea is a common disease in clinical practice. Probiotics are known to increase local immunity and reduce length of healing among diarrhea patients. Currently there are no guidelines related to the administration of probiotics as prevention of C. difficile reinfection in adult patients with antibiotic associated diarrhea. Objective: To determine the effectiveness of probiotics in preventing Clostridium difficile reinfection. Method: Literature searching through database, such as PubMed, Clinical Key, Science Direct, and Proquest. A critical review used appraisal sheet for systematic review from Oxford Center for Evidence Based Medicine in 2011. Result: Two meta-analysis studies with good validity. Goldenberg, et al, demonstrated the use of probiotics in the prevention of C. difficile infection with RR 0.62 (95% CI 0.30-0.52) and NNT 22. On the other hand, Shen, et al, obtained RR 0.42 (95 % CI: 0.3-0.5; p <0.001) with NNT 1.757. Conclusion: Probiotics have the potential to prevent Clostridium difficile reinfection.