Efficacy of Probiotics in Preventing Diarrhea Secondary to Pediatric Pneumonia and Influence on Intestinal Microecology and Immunity

Abstract

Background: Diarrhea secondary to pediatric pneumonia is often caused by the imbalance of intestinal microbiota due to prolonged use of antibiotics in children, and is characterized by symptoms such as abdominal pain, diarrhea, and vomiting. In severe cases, significant electrolyte and fluid imbalance may occur, which can be life-threatening. It is of great importance to prevent diarrhea secondary to pediatric pneumonia. Objective: This study was designed to evaluate the efficacy of probiotics in preventing diarrhea secondary to pediatric pneumonia by investigating the intestinal microecology and immune function recovery of patients. Methods: A total of 308 children with pediatric pneumonia were recruited from January 2019 to March 2021, among them 300 cases were studied after exclusion of 8 cases of dropouts. The children were assigned to receive either routine treatment (control group) or probiotics (treatment group) at a ratio of 1:1, resulting in 150 children in each group. The primary outcome was clinical efficacy, and the secondary endpoint included intestinal microecology and immune function. We used enzyme-linked immunosorbent assay (ELISA) to determine the levels of cluster differentiation 4⁺ (CD4+) T cell and CD8+ T cell and assessed the immune function. Results: A lower frequency of diarrhea and a shorter time-lapse before diarrhea episodes were shown in children treated with probiotics (14.66%) as compared to those with routine treatment (40.66%) (p < 0.05). Moreover, probiotics treatment resulted in markedly fewer and shorter diarrhea episodes and abridged length of hospital stay than routine management (p < 0.05). Probiotics provided significant improvement in the number of intestinal florae for the patients, as demonstrated by higher levels of bifidobacteria, lactobacilli, and enterococci and lower yeast levels than those with routine treatment (p < 0.05). Children in the probiotics treatment group showed markedly improved immune function than those in the routine management group, as evidenced by the higher CD4+ T cell and CD4+ T cell/CD8+ T cell levels and lower CD8+ T cell levels (p < 0.05). Conclusion: Probiotics were shown to have preventative and therapeutic effect in the treatment of diarrhea secondary to pediatric pneumonia, such as shortening the length of hospital stay of patients, and enhancing their intestinal microecology and immunity, thereby improving the prognosis of patients.