Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute diarrhea is defined as an abnormally frequent discharge of semisolid or fluid fecal matter from the bowel, lasting less than 14 days. More than three millions cases of acute diarrhea, presumably due to intestinal infections, are seen in general practice every year in France. Most of the cases are benign and resolve under symptomatic treatment within 3 days, without need for biological tests or antibiotics. In special contexts (septicemic syndrome, visible blood in stools, severe dehydration, patients at risk of severe sepsis [valvulopathy]), biologic tests and probabilist antibiotic treatment are required. Hygiene, rehydration and diet recommendations are always part of the treatment of acute diarrhea, in addition to the symptomatic treatment of diarrhea and other digestive symptoms. Antibiotic-associated diarrhea is clinically benign in most cases, and attributed to transient dysbiosis of gut microbiota. In the remaining cases, diarrhea is the clinical expression of intestinal infection by Clostridium difficile, that should be treated with metronidazole, or the clinical expression of a Klebsiella oxytoca-associated colitis that usually spontaneously resolves after stopping antibiotics.
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PMID:[Acute infectious diarrhea in adults: epidemiology and management]. 2325 55

Probiotics use has increased tremendously over the past ten years. This was coupled with a surge of data relating their importance in clinical practice. Antibiotic-associated diarrhea, whose frequency has risen recently, was one of the earliest targets with data published more than ten years ago. Unfortunately, available trials suffer from severe discrepancies associated with variability and heterogeneity of several factors. Most published randomized controlled trials and subsequent meta-analyses suggest benefit for probiotics in the prevention of antibiotic-associated diarrhea. The same seems to also apply when the data is examined for Clostridium difficile-associated colitis. However, the largest randomized double-blind placebo-controlled trial to date examining the use of a certain preparation of probiotics in antibiotic-associated diarrhea showed disappointing results, but it was flawed with several drawbacks. The commonest species of probiotics studied across most trials is Lactobacillus; however, other types have also shown similar benefit. Probiotics have enjoyed an impeccable safety reputation. Despite a few reports of severe infections sometimes leading to septicemia, most of the available trials confirm their harmless behavior and show similar adverse events compared to placebo. Since a consensus dictating its use is still lacking, it would be advisable at this point to suggest prophylactic use of probiotics to certain patients at risk for antibiotic-associated diarrhea or to those who suffered previous episodes.
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PMID:Probiotics for antibiotic-associated diarrhea: do we have a verdict? 2554 77