Terapi Zinc Probiotik

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Paediatrica Indonesiana

VOLUME 51 January N

Original

Comparison of zinc-probiotic combination

therapy to zinctherapy alone in reducing the severity of ac

diarrhea

Muhammad Hatta, upriatmo , Muhammad Ali , Atan !aas inuha"i, !erlian Ha# # #

%era &una 'asution $

Abstract iarrhea is defined as the passage of unloose or watery stools, at least threBackground !lthough the in"iden"e of diarrhea in #ndonesia

has de"lined in the last fi$e years, the ortality rate in "hildren

under fi$e years old is still high% &herefore, appropriate and "hanges in stool "onsisten"y,"oprehensi$e anageent of diarrhea is essential% &here ha$e

without 'lood or u"us in the stool, so'een any studies on the role of (in" therapy and pro'ioti" therapy

a""opanied 'y $oiting%Episodes of diarr1in redu"ing the se$erity of a"ute diarrhea, 'ut not any studiesgenerally a"ute, and in "ertain "ir"ustan"es ha$e "opared the use of a "o'ination of the two therapies to

(in" therapy alone%

Objective &o "opare the effi"a"y of (in")pro'ioti" "o'ination#n #ndonesia, diarrhea reains a leadin

therapy to (in" alone in redu"ing the se$erity of a"ute diarrhea%of death in infants and "hildren% BasedMethods *e "ondu"ted a randoi(ed, open)la'el, "ontrolled

and 5 years who et the "riteria were di$ided into two groups% under fi$e years of age%&here ha$e 'ee+

studies "ondu"ted on treatent of a"ute diaLactobacillus

the last few years, espe"ially in$ol$ing the useacidophilusand pro'ioti"s% in" has 'een shown to signi(in" sulphate at the sae dosage as group #% Measureent of disease

redu"e the fre-uen"y, se$erity, and or'

a"ute diarrhea% .)/Results Eighty su'0e"ts were enrolled, randoised, and di$ided

(in" alone% *e o'ser$ed signifi"ant differen"es in fre-uen"y of

&his study has 'een presented at . t h

nd t h

Conclusioneffe"ti$e in redu"ing the se$erity of a"ute diarrhea than (in"therapy alone in "hildren under fi$e years of age% (PaediatrIndones) $*##+##-./) Medi"al "hool, Uni$ersity of North uatraKeywords: acute diarrhea, zinc, probiotic,Lactobacillus acidophilus E)ail2 [email protected] Indones, Vol. 51, No. 1, Janu


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"uhammad #atta et al$

se$ere dehydration o""urred and anti'ioti"s sh

the duration of diarrhea%

to 'e effe"ti$e for treatent of a"ute diarrhea% &he Monitoring of the duration and fre

"o'ination of 'oth (in" and pro'ioti"s in the diets of diarrhea was done during hospitali(ation a

of "hildren aged less than 1 year has 'een shown the patient was dis"harged% &o3i"ity and side

to signifi"antly redu"e the se$erity and duration of relating to the adinistration of (in" and pr

diarrhea% were also o'ser$ed 4nausea, $oiting, a'doin

niss to redu"e the se$erity of a"ute diarrhea,

ore effe"ti$e than (in" alone in redu"ing the se$eritythe parents or "aregi$ers 'y telephone% &his stu

of a"ute diarrhea% &his study was designed to "opare

the effi"a"y of (in")pro'ioti" "o'ination therapy Medi"al "hool, Uni$ersity of North

with (in" therapy alone in redu"ing the se$erity of *e used $ersion 15 for data a

a"ute diarrhea% #ndependent t)test was used to assess the relat

'etween (in")pro'ioti" "o'ination ther

(in" alone as noinal s"ale with the duratMethods

were "onsidered signifi"ant at a pro'a'ility $

*e "ondu"ted an open, randoi(ed, "ontrolled trial

treat analysis)'ased study%

Medan, North uatra% *e in"luded "hildren

aged 1 onth to 5 years with a"ute diarrhea%0esults*e e3"luded those with se$ere alnutrition,

en"ephalitis, eningitis, sepsis, 'ron"hopneuonia,

iuno"oproised state, or those who had 'een

were di$ided into two groups 'y siple randoi(ationea"h2 those who re"ei$ed (in")pro'ioti" "o'

using rando ta'les% 6roup # re"ei$ed (in" sulfate

%igure #

re"ei$ed (in" sulfate at a the sae dose as 6roup #% t, 7

in" sulfate ta'lets were dissol$ed in 5 l of 'oiled

water% Both do"tors and parents were aware of the

therapies gi$en%E

*e did not perfor stool e3aination 'e"ause

of the high "ost re-uired% &he "ause of diarrhea was

* 8 88was "hara"teri(ed 'y a"ute diarrhea i3ed with 'lood,while "holera and diarrhea "aused 'y rota$irus was"hara"teri(ed 'y a"ute watery diarrhea% *e suspe"ted 9 o pl e te d in te r $ e n tio n a n d in " lu d e d9 o p le t e d in t e r $e n t io n a f o r f in a l a na l ys is f o r fi n : . ;%igure # % tudy algorith%$ Paediatr Indones, Vol. 51, No. 1, January !11


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&he ean fre-uen"y of diarrhea 'efore treatent

differen"es in diarrheal fre-uen"y in the two

fro the first to fourth days% 4

or "aregi$ers in either group reported re

diarrhea or "oplained of to3i"ity or side effe"

(in" group% 4 1able # asso"iated with (in" and pro'io

1able # % Baseline "hara"teristi"s

Characteristic in")ro'ioti" n:.; in" n:.;

Mean age, onth 4?%. 4>1%;.= >1

e3, n

Male >+

@eale 1?

>

Undergraduate 1;

6raduate >

Mother, n

Eleentary "hool +

Junior igh "hool ?

enior igh "hool >>

Undergraduate C

6raduate ;

arental #n"oe8onth

@ather, n

D Rp% 5;;%;;; >

Rp% 5;;%;;; Rp% 1%;;;%;;; 15

Rp% 1%;;;%;;; Rp% +%;;;%;;; 1C

F Rp% +%;;;%;;; 5

Mother, n

D Rp% 5;;%;;; >/

Rp% 5;;%;;; Rp% 1%;;;%;;; C

Rp% 1%;;;%;;; Rp% +%;;;%;;; /

F Rp% +%;;;%;;; ;

Mean fre-uen"y of diarrhea 'efore C%> 4+%1A=

treatent, ties8day 4= C%C 4>%..= ) >%?> to ) ;%.>> n dday .%/ 4>%+C= /%/ 4>%5A= ) +%.; to ) 1%1A+ t hday >%1 41%//= +%C 4>%+;= ) >%5A to ) ;%C;. t hday ;%C 41%..= 1%C 4>%;+= ) 1%C/ to ) ;%>C5 t hday ;%> 4;%5.= ;%? 41%.?= ) ;%A? to ;%>1/ t hday ;%; 4;%;;= ;%+ 41%;;= ) ;%5/ to ;%/?? day ;%; 4;%;;= ;%; 4;%15= ) ;%?5 to ;%;>t h Paediatr Indones, Vol. 51, No. 1, Janu


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#n this study, the fre-uen"y and duration of a"idophilus, as it ay 'e 0ust as effe"ti$e and

diarrhea, as well as length of hospital stay were lowerfewer side effe"ts "opared to li$e pro'ioti"s

in the "o'ination group than in the (in" group was no standard dose of pro'ioti" adini

1able 2 for a"ute diarrhea% Often the pro$isions of p

1able 2) @re-uen"y and duration of diarrhea, and length of hospital stay

6roup # 6roup ## A5G

4in")ro'ioti"= 4in"=

ean 4


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*e found no o'$ious reasons why the fre-uen"y of "holera in Bangladesh2 randoised "ontrolled tr

diarrhea in the fifth to se$enth days of therapy did not

differ in 'oth groups%

!nggarwal et al% used (in" suppleentation and

found that the duration of diarrhea after therapy was

+ days% *e had siilar results in our study% Length. #ndia2 a randoi(ed, dou'le)'lind, pla"e'o)"

of hospital stay "annot 'e used as an indi"ator of

therapeuti" su""ess due to any other fa"tors that

affe"t the length of patient hospitali(ation, su"h

as tie delays in hospital dis"harge "aused 'y the

parentsI re-uests or payent issues% #n our study,

La"to'a"illus therapy for a"ute infe"tious d

that intestinal re"o$ery in a"ute diarrhea o""urs of a diet "ontaining pro'ioti"s and (in" for the tre

ild diarrheal illness in "hildren younger than on

Liitations of this study were that the etiology

'lind study, although randoi(ation was done to

redu"e 'ias% *e "on"lude that a "o'ination of +5%

(in" and pro'ioti" therapy is ore effe"ti$e than 11% *apnir R!% in" defi"ien"y, alnutritio

(in" therapy alone in redu"ing the se$erity of a"ute

diarrhea in "hildren under fi$e years%

solutions2 e3periental assessent and e"h

Ac5no6ledgements

in rat ileu% ! J hysiol 6astrointest Li$epro'ioti" preparations in this study% !ll authors ha$e no "onfli"t

of interest on the data and "on"lusion reported in this paper%

0eferences

"aused 'y rota$irus in "hildren less than 5 years

and pro'a'ility of sewage "ontaination% J #slai"

hospitali(ed "hildren with a"ute watery diarrhea

.% !nggarwal R, ent( J, Miller M!% Role of (in" adinistrationin pre$ention of "hildhood diarrhea and respiratory illness2, Begu !, et al% in" suppleentation in "hildren with Paediatr Indones, Vol. 51, No. 1, Janu


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orphology of piglets that re"ei$ed pro'ioti"s with $ia'le or

La"to'a"illus rhanosus 66 de"rease tuor ne"rosis fa"tor)

e3periental study and a randoi(ed, dou'le)'lind

"ontrolled "lini"al trial to e$aluate the antise"retor

of La"to'a"illus a"idophilus strain LB against non

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