Bifidumbacterin 10ml liquid concentrate of bifidobacteria 10 pcs.

Release form

Several forms of this drug are available:

• dry Bifidumbacterin in bottles;
• Bifidumbacterin in ampoules;
• product in powder, in foil bags;
• Bifidumbacterin in capsules;
• vaginal suppositories Bifidumbacterin;
• liquid Bifidumbacterin – concentrate of bifidobacteria;
• Bifidumbacterin 1000 is available in tablets.

The tablet and suppository each contain 1 dose of the drug, all other indicated packages contain 5 doses. Which form of release of the drug is preferable in a particular case is determined by a specialist.

pharmachologic effect

The abstract indicates that the product has an antibacterial effect against a number of pathogenic (those that cause diseases in humans) and conditionally pathogenic (those that provoke the development of diseases in the presence of certain conditions) bacteria. In particular, live bifidobacteria act on enteropathogenic E. coli, staphylococci, shigella, and some types of yeast-like fungi.

The drug helps restore intestinal microflora, balances the vaginal microflora, normalizes the functioning of the gastrointestinal tract, has an immunomodulatory effect, and has a positive effect on the activity of metabolic processes.

Indications for use

The medicine is indicated for patients with the following diseases and conditions of the body:

• dysbacteriosis;
• acute intestinal infections;
• chronic inflammation of the small and large intestines;
• intestinal dysfunction associated with the development of dysbiosis;
• long-term intestinal dysfunction;
• transfer to artificial feeding of children in early infancy.

As part of a complex treatment, the drug is used in the treatment of children suffering from pneumonia and sepsis . It is used to sanitize the genital tract in women, to prepare for childbirth in women who have grade III-IV disturbances in the purity of vaginal secretions, and for senile colpitis (inflammation of the vaginal mucosa in older women). The medicine is also used to provide prevention of mastitis in women who are breastfeeding.

Probiotics for IBD

Inflammatory bowel diseases include ulcerative colitis (UC) and Crohn's disease (CD), idiopathic recurrent diseases in which chronic immune inflammation of various parts of the gastrointestinal tract is observed with the development of diarrhea and abdominal pain. UC and CD have both overlapping and independent clinical and pathological features.

Risk factors for the development of IBD include a family history of inflammatory bowel disease, social and geographic factors, stress, medications (nonsteroidal anti-inflammatory drugs), increased intestinal permeability, use of oral contraceptives, obesity, and a diet high in carbohydrates [9].

The pathogenesis of IBD is not fully understood, but genetic and environmental factors such as altered gut bacteria and increased intestinal permeability play a role in the dysregulation of intestinal immunity, leading to inflammatory bowel disease. It was not possible to detect a specific environmental factor, nutrition, or infectious agent that causes IBD. At the same time, scientific facts indicate a key role of the intestinal microbiota in the occurrence and progression of IBD [11, 12].

UC and CD have much in common in the morphological picture of inflammation, the mechanisms of its development and clinical manifestations. Unlike UC, which occurs with isolated damage to the colon, with CD, any part of the digestive tract can be involved in the pathological process. The clinical picture of CD is more mosaic; there are differences in types of complications, prognosis and response to therapy.

For the treatment of IBD, drugs 5-aminosalicylic acid (5-ASA), corticosteroids, azathioprine, methotrexate, 6-mercaptopurine, cyclosporine, antibodies to tumor necrosis factor and other biological therapies are used [13].

Since the microflora plays a role in the pathogenesis of IBD, a number of interventions may be aimed at modulating the intestinal microbiota. This effect is achieved in several ways: antibiotic therapy, the administration of pro- and prebiotics, changing the nature of the diet, etc. It is believed that probiotics containing viable organisms can have a positive effect on the intestinal microbiota and the course of the disease [14, 15].

In recent decades, data from many randomized clinical trials (RCTs) on the effectiveness of probiotics in IBD have been published all over the world, however, when considering all these works separately, it is impossible to get a holistic picture of their role in the treatment of this pathology. This is due both to the inconsistency of the results of these RCTs and to the significant heterogeneity of the comparison groups, different types and dosages of probiotics, different follow-up periods, etc. In addition, in many RCTs the compared groups were small in number, which is why when comparing them there was statistical significance cannot be achieved. In this regard, meta-analyses emerged that synthesized data from several individual RCTs.

In total, by 2016, 36 meta-analyses had been published that synthesized data from RCTs that examined the effectiveness of probiotics in specific subgroups of patients with IBD, but none of them pooled the entire population of RCTs on this problem.

When assessing the methodological quality of these meta-analyses using the Canadian Agency for Drugs and Technologies in Health rating system, 4, 24, and 8 of them were classified as being of high, moderate, and low quality, respectively, and some of them were serious limitations [16]. For example, several meta-analyses combined RCTs of probiotics and synbiotics, while others simultaneously assessed RCTs conducted in pediatric and adult populations [17–22].

The most modern, complete and structured view of the currently accumulated evidence base for the use of probiotics in IBD in adults is presented in a systematic review with a meta-analysis of RCTs, the results of which were published in 2017 [23].

A total of 22 RCTs were included in the review, which studied the effectiveness of probiotics in inducing remission in active UC (8 RCTs), anti-relapse effectiveness in UC (6 RCTs), effectiveness in inducing remission in active CD (2 RCTs), anti-relapse effectiveness in CD ( 2 RCTs) and after bowel resection for CD (4 RCTs).

Efficacy of probiotics in inducing remission in active ulcerative colitis

A total of 8 RCTs were included in the review, which examined the effectiveness of probiotics in inducing remission in active UC. One of them compared probiotics with 5-ASA, and the other 7 were placebo-controlled. An RCT comparing probiotics ( Escherichia
Coli Nissle 1917)
and 5-ASA (mesalazine) to induce remission in active UC included 116 patients. Treatment in both groups was carried out for 12 weeks; When included in the RCT, patients in both groups received gentamicin for 1 week [24].

18 (31.6%) of 57 patients receiving probiotics and 15 (25.4%) of 59 patients receiving 5-ASA did not achieve remission (relative risk of not achieving remission 1.24; 95% CI 0. 70—2.22). Adverse treatment side effects occurred in 9 (15.8%) patients in the probiotic group and 7 (11.9%) in the 5-ASA group ( p

=0,54).

Seven placebo-controlled RCTs [25–31] included a total of 535 patients with active UC. A total of 166 (56.3%) of 295 patients receiving probiotics did not achieve remission compared with 159 (66.3%) of 240 receiving placebo (RR 0.86; 95% CI 0.68 to 1.08 ). Data on adverse treatment effects were reported in 6 RCTs [25–28, 30, 31]. Adverse events occurred in 69 (24.6%) of 281 patients receiving probiotics and 28 (12.4%) of 226 randomized to placebo, although this difference was not statistically significant (RR 1.21; 95% CI 0.64-2.27).

In 3 studies with a total number of 319 patients, VSL#3 (Ferring Pharmaceuticals Ltd., UK) was used, a combination probiotic consisting of strains of Bifidobacterium
breve , B. longum , B. _ infantis , Lactobacillus acidophilus , L. _ plantarum , L. _ paracasei , L. _ bulgaricus
and
Streptococcus thermophilus
[26, 29, 30]
.
A separate meta-analysis of these 3 RCTs showed that 91 (56.2%) of 162 patients treated with VSL#3 and 118 (75.2%) of 157 placebo groups failed to achieve remission (RR 0.74, 95 % CI 0.63–0.87). The number of patients needed to treat with VSL#3 to prevent one failure to achieve remission in active UC (NNT) was 5 (95% CI 4–10). Two RCTs involving 140 patients used the probiotic Escherichia
Coli Nissle 1917
. Fifty-six (58.9%) of 95 patients receiving the probiotic failed to achieve remission compared with 18 (40.0%) of 45 in the placebo groups (RR failure to achieve remission 1.56; 95% CI 0.44, 5.53 ).

Anti-relapse effectiveness of probiotics in ulcerative colitis

Three of the six RCTs that examined the antirelapse efficacy of probiotics in patients with clinical remission of UC compared probiotics with 5-ASA [32–34], and three RCTs [35–37] were placebo-controlled. The 3 RCTs that used 5-ASA as a comparison included a total of 555 patients with clinical remission of UC.

Relapse occurred in 110 (39.7%) of 277 patients receiving probiotics and 109 (39.2%) of 278 receiving 5-ASA. The RR of relapse in patients with clinical remission of UC treated with probiotics versus 5-ASA was 1.02 (95% CI 0.85–1.23). Adverse side effects were reported in 73 (25.6%) patients receiving probiotics and 66 (23.2%) patients receiving 5-ASA (RR 1.09; 95% CI 0.71–1.67) .

Three placebo-controlled RCTs [35–37] included 122 patients with clinical remission of UC, of ​​whom relapse occurred in 32 (49.2%) of 65 patients receiving probiotics and 42 (73.7%) of 57 groups. placebo (RR 0.62; 95% CI 0.33–1.16). Only one of these RCTs reported adverse events, all of which occurred in placebo users [37].

Efficacy of probiotics in inducing remission in active Crohn's disease

The effectiveness of probiotics in inducing remission in active CD was studied in only 2 placebo-controlled RCTs, including a total of 37 patients [38, 39]. Of these, 6 (31.6%) of 19 patients receiving probiotics failed to achieve remission compared with 6 (33.3%) of 18 in the placebo groups (RR 0.99; 95% CI 0.57-1. 72). Only one of these RCTs reported adverse events that occurred in the placebo group only [38].

Anti-relapse effectiveness of probiotics in Crohn's disease

The review included only 2 RCTs ( n

=195), which compared the anti-relapse effectiveness of probiotics [40, 41].
Relapse occurred in 52 (52%) of 100 patients receiving probiotics and 50 (52.6%) of 95 placebo patients (RR of relapse, 1.03; 95% CI, 0.70 to 1.51). Only one of these RCTs [40] reported adverse events, which occurred in 49 (58.3%) of 84 patients in the probiotic group and 45 (55.6%) of 81 in the placebo group ( p =
0.72). .

Anti-relapse effectiveness of probiotics after bowel resection for Crohn's disease

A total of 4 placebo-controlled RCTs were included in the review ( n

=333), which examined the effectiveness of probiotics in preventing either clinical or endoscopic recurrence of CD during remission after bowel resection [43–46]. In 3 of these 4 RCTs, the outcome studied was clinical relapse, which occurred in 28 (26.7%) of 105 patients receiving probiotics and 28 (25.9%) of 108 receiving placebo (RR 1.06, 95 % CI 0.59, 1.92) [43–45].

Information on endoscopic recurrence of disease activity was provided in all 4 RCTs. To determine endoscopic recurrence, the Rutgeerts scale was used [42] with a score from 1 to 4.

The results of these RCTs showed that probiotics do not prevent endoscopic recurrence of CD. Three RCTs reported adverse events occurring in 39 (30.2%) of 129 probiotic-treated patients and 52 (38.8%) of 134 placebo-treated patients (RR 0.81, 95% CI 0.61–1.08) [43, 45, 46].

In summary, this systematic review and meta-analysis demonstrated that the probiotic VSL#3 helps induce remission in active UC with NNT=5. It has also been found that probiotics may be as effective as 5-ASA in preventing relapse of UC that is in remission. There was no benefit of probiotics over placebo in inducing remission in active CD, preventing relapse of CD in remission, or preventing clinical or endoscopic recurrence of CD after surgical treatment. Comparison of the incidence of adverse events during treatment with probiotics, placebo and 5-ASA did not reveal statistically significant differences.

Instructions for use of Bifidumbacterin (Method and dosage)

If dry Bifidumbacterin is used to treat children and adults, the instructions for use should be taken into account. Adult patients who suffer from dysbiosis should take 5 doses of the drug orally three times a day. The doctor determines how long you need to adhere to this treatment regimen. The powder is usually taken for 2 weeks to 3 months. To prevent the development of dysbacteriosis, 5 doses 1-2 times a day should be taken for 1-2 weeks.

For children who are at risk from birth for the development of intestinal dysbiosis, 1-2 doses should be taken orally three times daily. After six months, the daily dose increases to 3 doses. The product should be given to children immediately before feeding. After one year of age, children receive 5 doses 2 or 3 times a day.

If prevention of dysbacteriosis is necessary for children suffering from pneumonia, sepsis, etc., 2-3 doses of the drug should be taken per day. If a child has disturbances in the functioning of the gastrointestinal tract, the threat of enterocolitis, 10 doses should be taken per day.

The instructions for using Bifidumbacterin in ampoules are similar, since the drug ampoules each contain 5 doses.

Microgen Bifidumbacterin dry, which is contained in the package, should be poured into a container and water should be added to it (5 ml per 1 dose). Next, the product is mixed for about 10 minutes. The dissolved drug cannot be stored; the remaining undissolved part can be stored for no more than one day.

If the patient uses liquid Bifidumbacterin, the instructions for use indicate that it can be used both orally and topically. The drug concentrate is packaged in bottles. Liquid Bifidumbacterin is used to prevent mastitis. In this case, you need to treat the nipple and the area around it. For this, a cotton swab is used, the treatment is carried out half an hour before feeding. The procedure must be carried out for 5 days, with 2-2.5 doses used each time. For skin lesions, the product is applied to the affected areas.

The liquid drug should be taken orally in the following daily dosage: adults can take 3–5 ml, children in the first year of life — 1 ml, children under 3 years old — 1–2 ml, children under 7 years old — 2–3 ml. Please note that 1 ml of product is 20 drops.

The liquid drug is also administered rectally as a microenema. To do this, 3–5 ml of the product must be diluted in 50 ml of water.

For vaginal use, 3-5 ml of concentrate is applied to the surface of the tampon, which is soaked in water or saline. This tampon should remain in the vagina for 4–8 hours.

If Bifidumbacterin suppositories are prescribed, the instructions for use provide for rectal administration of 1-2 suppositories once or twice a day for intestinal diseases. Treatment lasts from 7 to 30 days. For gynecological diseases, 1 suppository is removed vaginally twice a day for 5-10 days.

Bifidumbacterin in capsules is prescribed to adult patients and children over 3 years of age. In childhood, you need to take 1 capsule 3 or 4 times a day. Adults take 2 capsules 2 or 3 times a day. For some diseases (acute infections), children are prescribed 3-5 capsules, while tablets in this dose should be taken up to 6 times a day. For acute infections, adults take 10 tablets three times a day. Therapy lasts up to 14 days.

Your doctor will tell you more about how to take Bifidumbacterin for adults and children with a specific disease.

Bifidumbacterin 10ml liquid concentrate of bifidobacteria 10 pcs.

pharmachologic effect

Immunomodulatory, normalizing intestinal microflora. It is an antagonist of a wide range of pathogenic and opportunistic microorganisms; activates the digestion process and gastrointestinal tract functions, metabolic processes and nonspecific resistance of the body.

Composition and release form Bifidumbacterin 10ml liquid concentrate of bifidobacteria 10 pcs.

Concentrated microbial mass of 5 strains of bifidobacteria (Bifidobacterium longum, Bifidobacterium bifidum, Bifidobacterium adolescentis, Bifidobacterium bifidum 1, Bifidobacterium bifidum 791), which are in a living active form (1010-1011 cfu per 1 cm3).

Description of the dosage form

A crystalline or porous mass of various shades of beige or whitish-gray, with a specific odor. The reconstituted drug is a homogeneous suspension of beige or whitish-gray color.

Characteristic

Liquid bifidobacterium concentrate is an innovative bifidobacteria-containing probiotic preparation - it is a concentrated microbial mass of 5 strains of bifidobacteria, which are in a live active form (1010-1011 cfu per 1 cm3).

The human microflora is normally represented by 70-90% bifidobacteria, which play a major role in the digestive processes.

Bifidobacteria have immunostimulating activity and have a beneficial effect on the body in diseases of the gastrointestinal tract. Bifidobacteria produce enzymes, vitamins B and K, and improve the absorption of fat-soluble vitamins and microelements. In addition, they help remove toxins from the body and reduce cholesterol levels.

Environmental pollution, increased radiation, stress, the use of chemicals in the food industry and medicine, and intestinal infections cause partial or complete death of bifidobacteria. This further leads to the development of pathogenic microflora and the formation of dysbacteriosis.

As representatives of the normal intestinal microflora, bifidobacteria longum and bifidum suppress the growth of a wide range of pathogenic microorganisms. The high level and predominance of bifidobacteria in the intestines, achieved with the use of CBZH (liquid bifidobacterium concentrate), normalizes the activity of the gastrointestinal tract, improves metabolic processes in the human body, and increases its immune status.

Directions for use and doses

For intestinal dysbiosis, Bifidumbacterin is used orally.

In obstetric and gynecological practice - intravaginally.

Dissolve the contents of the bottle with boiled water at room temperature at the rate of 5 ml (teaspoon) of water per 1 dose of the drug.

Dissolution is carried out as follows: pour the required amount of water into a glass (in accordance with the number of doses indicated on the bottle); open the bottle by removing the cap and stopper; transfer a small amount of water from the glass into the bottle; after dissolution (the drug dissolves in no more than 10 minutes), transfer the contents of the bottle into the same glass and mix.

One teaspoon of the drug dissolved in this way is 1 dose. The dissolved drug cannot be stored.

Take the required number of doses (respectively, teaspoons) 20-30 minutes before meals. The drug can be given to infants immediately before feeding.

For dysbacteriosis caused by intestinal diseases in children of the first half of life, the drug is prescribed 5 doses per dose 2 times a day, for children of the second half of the year and older - 5 doses 3 times a day.

To prevent dysbacteriosis, it is advisable for newborns at risk to start using the drug in the maternity ward from the first day of life until discharge, 2.5 doses per dose 2 times a day.

For severe forms of dysbacteriosis in children, which are caused by sepsis, pneumonia and other purulent-infectious diseases, the drug is prescribed 5 doses 3 times a day in combination with generally accepted methods of treating the underlying disease. In this group of children with the threat of necrotizing ulcerative enterocolitis, the dosage of Bifidumbacterin is increased to 20 doses per day.

For dysbiosis in adults caused by acute and chronic inflammatory diseases of the small and large intestines, colitis and enterocolitis, the drug is recommended to take 5 doses 2-3 times a day.

The duration of treatment with Bifidumbacterin is determined by the severity of clinical manifestations, the age of the patient and is 2-4 weeks, and in some cases up to 3 months.

For dysbiosis and inflammatory diseases of the female genitalia and prenatal preparation of pregnant women at risk, Bifidumbacterin is prescribed 5-10 doses once a day for 5-8 days under the control of restoration of the purity of vaginal secretions to the I-II degree and the disappearance of clinical symptoms of inflammation. For intravaginal use, insert a sterile tampon soaked in the drug into the vagina and leave for 2-3 hours. If necessary, the course of treatment with Bifidumbacterin can be repeated.

For preventive purposes, 5 doses are prescribed 1-2 times a day for 1-2 weeks.

Indications for use Bifidumbacterin 10ml liquid concentrate of bifidobacteria 10 pcs.

• Acute intestinal infections.
• Acute and chronic intestinal diseases.
• Constipation.
• Gastrointestinal diseases of various etiologies (gastritis, gastrodoudenitis, colitis).
• Allergic diseases (bronchial asthma, eczema, neurodermatitis, atopic dermatitis).
• For vaginitis of various etiologies in children and adults.

Contraindications

Individual intolerance to product components.

Application Bifidumbacterin 10ml liquid concentrate of bifidobacteria 10 pcs. during pregnancy and breastfeeding

Bifidobacteria are representatives of the normal human microflora. Therefore, drugs made on their basis can be used during pregnancy and lactation.

special instructions

The drug does not affect the performance of activities that require special attention and quick reactions (driving vehicles, machinery, etc.).

The drug is stored in accordance with SP 3.3.2.1248-03 at a temperature of 2 to 10 °C.

Keep out of the reach of children.

Transportation conditions: the drug is transported in accordance with SP 3.3.2.1248-03 at a temperature of 2 to 10 °C.

The drug is not suitable for use:

• expired;
• without marking;
• the integrity of the packaging has been damaged;
• with changed physical properties

Overdose

No cases of overdose have been reported.

Side effects Bifidumbacterin 10ml liquid concentrate of bifidobacteria 10 pcs.

Not identified.

Drug interactions

The use of Bifidumbacterin can be combined with the simultaneous administration of antiviral and immunomodulatory therapy.

special instructions

This drug is prescribed with caution to people with lactase deficiency.

When consulting the instructions on how to drink Bifidumbacterin for adults or how to give this medicine to a child, you should take into account that it cannot be dissolved in water whose temperature exceeds 40 °C. Do not store the prepared solution. You should carefully study the instructions on how to dilute 5 doses of the product or use the product in a different dosage.

You cannot use a product for treatment if the integrity of its packaging has been damaged.

When using suppositories, you can simultaneously treat with antiviral, immunostimulating, and antibacterial drugs. Do not use candles that have the aroma of rancid oil.

How to use Bifidumbacterin powder

The dry preparation should be taken orally. Adults, depending on the condition, require from 1 to 5 doses of the drug per dose up to three times a day.

1. The contents of the package must first be diluted with several tablespoons of warm water: about 5 ml per dose.
2. Stir for 2-3 minutes and drink.
3. To improve the effect, it is recommended to increase the proportion of dairy products and vegetables in the diet.

The prepared solution cannot be stored; it must be used immediately. Course of continuous treatment: from 2 to 12 weeks.

Bifidumbacterin analogs

Level 4 ATC code matches:
Biobacton

Lactobacterin

Bactisubtil

Sporobacterin

Hilak forte

Subalin

Linex Forte

Linex

Florin Forte

Biosporin

Bifiliz

Probifor

Colibacterin

Bifidumbacterin Forte

Lacidophilus

Bifiform

Bificol

Acipol

Enterol

There are a number of analogues of this medicine that have a similar effect. These are the medicines:

• Bifiform
• Probifor
• Bifinorm
• Biolact

They also contain live bifidobacteria, which suppress the activity of pathogenic microorganisms. There are both cheaper analogues and drugs whose price is higher.

Lactobacterin or Bifidumbacterin - which is better?

Both of these products are probiotics , that is, preparations that contain dried cultures of living bacteria. However, Lactobacterin contains lactobacilli of the Plantarum species, and Bifidumbacterin contains bifidobacteria . The action of these components is approximately the same. However, there are also differences. In particular, Bifidumbacterin is more often prescribed for infants, since bifidobacteria predominate in the intestines of infants.

How to take Bifidumbacterin and Lactobacterin together, and whether it is worth doing this in a particular case, you need to find out from your doctor. Lactobacterin and Bifidumbacterin at the same time can ultimately produce a more pronounced effect. But every patient, especially children, should take these medications according to the regimen prescribed by the doctor.

Bifidumbacterin Forte or Bifidumbacterin - which is better?

Bifidumbacterin Forte is prescribed as a complex remedy. This is an improved dosage form, which contains biomass of living bifidobacteria adsorbed on stone activated carbon. As a result, the drug acts faster when it enters the intestines.

The use of probiotics in infectious diseases

Acute infectious diarrhea

WHO defines diarrhea as loose or watery stools 3 times a day or more or more often than usual for a particular person. Diarrhea is considered acute if its duration is less than 14 days. Severe diarrhea causes dehydration and can be life-threatening, especially in young children and people who are malnourished or have weakened immune systems. However, oral rehydration does not reduce the frequency of bowel movements or shorten the duration of diarrhea [60]. Therefore, in addition to oral or intravenous rehydration, various treatment methods are used, including probiotics [61, 62].

A Cochrane systematic review (2010), including 63 RCTs (7 in adults and 56 in children) with a total of 8014 participants (1525 adults and 6489 children), examined the effect of various probiotic preparations on clinical outcomes of infectious diarrhea [63]. The authors were unable to assess the effectiveness of probiotics in adults with infectious diarrhea due to heterogeneity in determining outcomes and duration of diarrhea.

Among children, probiotics reduced the mean duration of diarrhea by an average of 24.8 hours (95% CI 33.6 - -15.9), as well as the frequency of bowel movements on day 2 after the start of treatment (standardized mean difference -0.80; 95 % CI -1.14 - -0.45). Probiotics that significantly reduced the duration of diarrhea were L. casei GG

and
S. boulardii
, as well as a combination of
L. delbrueckii, L. acidophilus, S. thermophilus, Bacillus bifidum
and
S. boulardii
, or a combination of
L. acidophilus, L. rhamnosus, B. longum
and
S. boulardii
.

In a meta-analysis of 9 placebo-controlled RCTs including 765 children, C. Van Niel et al. [64] assessed the effect of Lactobacillus

on the duration of symptoms of acute infectious diarrhea. It was found that probiotics reduced the duration of diarrhea by 0.7 days and its frequency on the 2nd day to 1.6 times a day. According to the results of the meta-analysis, the patient needs to receive a minimum of 10 million CFU during the first 48 hours to reduce the duration of diarrhea by more than half a day.

Eight RCTs examining the effectiveness of probiotics in the treatment of acute infectious diarrhea in children were included in a systematic review by J. Applegate et al. [65]. The studies used both different combinations of probiotics and mono-strains. The results showed a reduction in the duration of diarrhea by 14% (95% CI 24.2-3.8), and the frequency of bowel movements on the 2nd day of treatment by 13.1% (95% CI -25.3 - -0.8% ).

In 2014, a review by the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) on the use of probiotics in acute gastroenteritis was published [66]. From the review it follows that their use leads to a reduction in the duration of diarrhea by approximately one day. The effectiveness of probiotics depends on the strain and dose used. Probiotics with a higher level of evidence and stronger recommendation are L. rhamnosus GG

and
Saccharomyces boulardii
.
The probiotic strains L. reuteri DSM 17938
and
L. acidophilus LB
have lower strength of recommendation due to weak evidence. Other probiotics cannot be recommended.

In a meta-analysis by S. Sazawal et al. [67] included 34 placebo-controlled RCTs examining the preventive efficacy of probiotics against different types of acute diarrhea in both adults and children. Probiotics reduced the risk of antibiotic-associated diarrhea by 52% (95% CI 35-65), the risk of traveler's diarrhea by 8% (95% CI 6-21) and acute diarrhea from various causes by 34% (95% CI 8-53).

In children, taking probiotics led to a reduction in the risk of diarrhea by 57% (95% CI 35-71), in adults - by 26% (95% CI 7-49). Preventive efficacy of probiotic strains S. boulardii, L. rhamnosus GG, L. acidophilus, L. bulgaricus

either alone or in combination of two or more strains did not differ significantly.

The results of the above studies suggest that probiotics for the treatment of acute infectious diarrhea should not be used in adults due to the lack of convincing evidence of their effectiveness, but they may be recommended for the treatment of acute infectious diarrhea in children.

Traveler's diarrhea

Traveler's diarrhea (TD) is diarrhea that occurs as a result of an acute intestinal infection of a viral, bacterial or parasitic nature acquired during a trip to another country. Escherichia coli, widespread throughout the world.

, rotaviruses, shigella, salmonella and
Campilobacter jejuni
. The main measure to prevent DP is strict adherence to the rules of personal hygiene, but attempts are being made to prevent it with the help of probiotics.

The results of a meta-analysis of 12 blinded RCTs [68] showed that in 6 of them, taking probiotics helped prevent D.P. One showed a trend favoring the use of probiotics, and 5 RCTs found no significant difference between probiotic and control groups. When all 12 RCTs were included in the meta-analysis, there was a positive effect in favor of probiotic use (RR 0.85; 95% CI 0.79–0.91). of S. were effective in preventing DP .
boulardii
and a mixture
of L. acidophilus
and
B. _ bifidum
.

However, due to the fact that 5 RCTs found no benefit from probiotics, it should be considered that the evidence accumulated to date is insufficient to recommend the use of probiotics for the prevention of DP. Conflicting results from RCTs may be due to differences in study populations and travel destinations, type of probiotics, dose, and duration of treatment. Further studies controlling for these factors are needed to elucidate the role of probiotics in preventing DP.

Clostridium difficile infection

Clostridium difficile infection

(CD infection, CD-associated diarrhea) is the most common cause of antibiotic-associated diarrhea. Since 2000, the prevalence of CD infection has increased significantly. The main risk factors for developing CD infection are older age, hospitalization, antibiotic use, immunosuppression, gastrointestinal surgery and the use of proton pump inhibitors [69].

Probiotics in the treatment of CD infection

The possibility of treating CD infection was analyzed in a Cochrane review [70], which included 4 RCTs that examined the use of probiotics in combination with antibiotics. 3 RCTs have been conducted using S. boulardii

and one with
L. plantarum
for the treatment of an initial episode or relapse of CD infection in adults.
The number of patients was small, and there were flaws in the methodology for conducting RCTs. Only one RCT using S. boulardii
showed the effectiveness of this probiotic, which reduced the duration of diarrhea (RR 1.33; 95% CI 1.02-1.74) and the risk of relapse after stopping treatment (RR 0.59; 95% CI 0.35–0.98). Three other RCTs showed that the use of a combination of probiotics and an antibiotic was not superior to the use of an antibiotic alone in terms of duration or intensity of diarrhea, risk of recurrence, or side effects.

Newborns

Bifidumbacterin for newborns is widely used to eliminate dysbiosis and relieve babies from colic. The instructions for Bifidumbacterin for newborns indicate that the drug is indicated for the treatment of premature babies, children born by cesarean section , in the presence of intestinal infections, etc.

Reviews from parents are mostly positive, saying that the product works effectively. At the same time, parents should clearly know how to dilute Bifidumbacterin for newborns and how to take the drug. You can learn how to give the drug to newborns from the instructions, or use the regimen prescribed by the pediatrician. It is important not to store diluted powder.

Depending on how severe the disease is, the treatment period lasts from one week to several months. It is necessary to give the child the drug at a time when his stomach is empty, that is, before meals - 30 minutes or after meals - after one hour. You can give the remedy before going to bed, at night.

Some parents are interested in whether this drug can be added to the mixture. Experts believe that diluting the drug in formula milk is acceptable. But at the same time, its effectiveness may be somewhat less, since it is advisable to take the drug on an empty stomach.

Bifidumbacterin forte powder 5 doses pack N 10

Release form, packaging and composition of the drug Bifidumbacterin Forte®

Powder for oral administration is light gray to dark gray in color with black coal particles and possible beige inclusions, with a faint sour milk odor.

1 pack (5 doses)

Bifidobacterium bifidum (sorbed on activated carbon) at least 50 million CFU

Excipients: lactose.

Clinical and pharmacological group: A drug that regulates the balance of intestinal microflora (probiotic)

Pharmacotherapeutic group: MIBP-eubiotic

pharmachologic effect

A drug of biological origin that regulates the balance of intestinal microflora, a probiotic.

The effect of the drug is due to the high concentration of bifidobacteria sorbed on activated carbon particles, which are antagonists of a wide range of pathogenic (including Shigella spp., Salmonella spp., Staphylococcus aureus) and conditionally pathogenic microorganisms (including Proteus spp., Klebsiella spp .).

Bifidobacteria sorbed on a specially prepared carrier provide increased clinical effectiveness and rapid restoration of normal microflora. Microflora, being a natural biosorbent, accumulates significant quantities of toxic substances entering from the outside or formed in the body and decomposes them into non-toxic components. Sorbed bifidobacteria, forming microcolonies, intensively activate restoration and metabolic processes, parietal digestion, synthesis of vitamins and amino acids, and the body’s immune defense.

Indications of the drug Bifidumbacterin Forte®

As monotherapy or as part of complex therapy:

intestinal dysbiosis;

acute intestinal infections of established (shigellosis, salmonellosis, staphylococcal enterocolitis, rotavirus infection) and unknown etiology;

food poisoning;

ARVI;

chronic diseases affecting the gastrointestinal tract (peptic ulcer of the stomach and duodenum, pancreatitis, cholecystitis, diseases of the liver and biliary tract), accompanied by intestinal dysbiosis;

chronic constipation;

malabsorption syndrome;

allergic diseases accompanied by intestinal dysbiosis;

pneumonia, acute and chronic bronchitis, inflammatory diseases of the urogenital tract, accompanied by intestinal dysbiosis;

intestinal dysbiosis caused by taking antibiotics, antibacterial drugs, hormones, NSAIDs;

diarrhea in patients receiving long-term treatment with antibiotics and other antibacterial drugs;

correction of intestinal microbiocenosis and prevention of purulent-inflammatory diseases in surgical patients during the period of preoperative preparation and after operations on the intestines, liver, and pancreas.

For the purpose of prevention

nosocomial infections in maternity hospitals and hospitals;

dysbacteriosis in children and adults who often suffer from ARVI.

Dosage regimen

The drug is taken orally during meals, if necessary - regardless of meals.

The drug in capsule form is prescribed to adults and children aged 3 years and older. Capsules are taken with boiled water or fermented milk product. For children, if necessary, the capsules are opened and its contents are mixed with liquid food, preferably a fermented milk product. The contents of the capsule can be mixed with 20-50 ml of boiled water at room temperature, which forms a cloudy suspension with black sorbent particles. The resulting aqueous suspension should be drunk without achieving complete dissolution.

The drug in powder form for oral administration is prescribed to adults and children of all age groups. Before use, the powder is mixed with liquid food, preferably with a fermented milk product, for newborns and infants - with mother's milk or formula for artificial feeding. The powder can be mixed with 30-50 ml of boiled water at room temperature, which forms a cloudy suspension with black sorbent particles. The resulting aqueous suspension should be drunk without achieving complete dissolution.

Depending on the severity of the disease, Bifidumbacterin forte is used in regular or increased doses.

For the purpose of treatment, the drug in usual doses is prescribed to patients of all age groups.

The usual dose for adults is 2 capsules or 2 sachets 2-3 times a day; for children aged 3 years and older - 1 capsule 3-4 times / day, for children aged 1 year and older - 1 sachet 3-4 times / day, for children under 1 year - 1 sachet 2-3 times / days

The course of treatment for acute intestinal infections and food toxic infections is 5-7 days, for other diseases - 15-21 days, depending on the nature and severity of the disease. If necessary, courses of treatment can be repeated 2-3 times, each course is carried out a month after the end of the previous course of treatment.

For surgical pathology, the drug is used for 3-5 days before surgery and for 10-15 days after surgery: adults are prescribed 2 capsules or 2 sachets 3 times a day; for children aged 3 years and older - 1 capsule 3-4 times/day, for children aged 1 year and older - 1 sachet 3-4 times/day, for children under 1 year - 1 sachet 3 times/day.

For the purpose of treatment, the drug is prescribed in increased doses to adults and children aged 1 year and older.

For acute intestinal infection and acute respiratory viral infection, the drug is prescribed from the first day of the disease: adults - 10 capsules or 10 sachets 3 times a day; for children aged 3 years and older - 3-5 capsules every 2 hours up to 6 times a day, for children aged 1 year and older - 5 sachets 6 times a day. The course of treatment is 1-3 days, depending on the severity of the condition.

For chronic gastrointestinal diseases, adults are prescribed 10 capsules or 10 sachets 1-3 times a day; for children aged 3 years and older - 5 capsules 1-3 times/day, for children aged 1 year and older - 5 sachets 1-3 times/day. The course of treatment is 10-14 days.

When used in children, it is recommended to open the capsules and mix their contents with 50 ml of boiled water at room temperature.

For the purpose of prevention, Bifidumbacterin forte is prescribed to adults and children over 3 years old, 1-2 capsules or 1-2 sachets 1-2 times a day; children under 1 year of age - 1 sachet 1 time/day. The preventive course is 10-15 days 2-3 times a year. To prevent nosocomial infections in maternity hospitals and hospitals, the drug is used for 5-10 days.

Side effect

When used according to indications in recommended doses, no side effects of the drug have been established.

Contraindications for use

individual intolerance to the drug.

Use during pregnancy and breastfeeding

The drug is approved for use during pregnancy and lactation (breastfeeding).

Use in children

The drug is used in children (see Dosage regimen).

special instructions

The drug should be used with caution in case of lactase deficiency.

Overdose

An overdose of the drug Bifidumbacterin forte is impossible due to the lack of cumulative effect.

Drug interactions

When taken simultaneously with vitamins (especially group B), the effect of the drug is enhanced.

When taken with antibiotics, the therapeutic effectiveness of the drug may be reduced.

Storage conditions for the drug Bifidumbacterin Forte®

Packages should be stored at a temperature not exceeding 10°C. The lower temperature limit is not limited. Transportation is carried out at a temperature not exceeding 10°C; Transportation at temperatures up to 20°C is allowed for no more than 10 days. Capsules should be stored at temperatures between 2° and 10°C.

Reviews about Bifidumbacterin

In most cases, reviews of Bifidumbacterin for newborns that parents leave on the forum are positive. It is noted that after prescribing Bifidumbacterin for children, their anxiety during colic disappears, and dysbacteriosis is cured. Parents also mention that the drug is easy to use.

Women often leave positive reviews about Bifidumbacterin suppositories in gynecology. According to patients, they help effectively cure vaginal dysbiosis ; suppositories are also effective for thrush. The product also has a positive effect after taking a course of antibiotics, eliminating the symptoms of intestinal dysbiosis. Some patients mention the positive effect of the product when used to cleanse the body. In particular, it is noted that the medicine helps get rid of acne.

Bifidumbacterin price, where to buy

The price of dry Bifidumbacterin (30 sachets) is on average 250 rubles. The price of Bifidumbacterin for newborns (ampoules, 10 pcs.) is 90 rubles. The price of the same drug in Ukraine is on average 70-90 UAH. You can buy Bifidumbacterin powder in Kyiv for a price starting from 70 hryvnia.

The price of Bifidumbacterin liquid (10 bottles of 10 ml each) is approximately 950 rubles. The price of Bifidumbacterin suppositories is from 90 rubles (10 pcs.) The price of Bifidumbacterin tablets is from 90 rubles. for 30 pcs. You can buy candles in Ukraine (Kharkov, Odessa and other cities) for prices starting from 100 UAH.

You can find out how much each form of the drug costs (capsules, tablets, etc.) in a specific pharmacy chain.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Bifidumbacterin-1000 tablets 300 mg 30 pcs. Ekko plus
  117 rub. order
• Bifidumbacterin liquid concentrate bottle 10ml 5 pcs. Bio Long Life LLC

  400 rub. order

• Bifidumbacterin liquid concentrate bottle 10 ml 10 pcs. Bio Long Life LLC

  RUR 723 order

• Bifidumbacterin suppositories for vaginas. and rect. input 1 dose 10 pcs. JSC Vitapharma

  106 rub. order

• Bifidumbacterin liquid concentrate bottle 10ml 20 pcs (dietary supplement)Bio Long Life LLC

  RUB 1,123 order

Pharmacy Dialogue

• Bifidumbacterin bottle 5 doses No. 10Ecopolis

  95 rub. order

• Bifidumbacterin suppositories No. 10 Lanafarm LLC

  84 rub. order

• Bifidumbacterin suppositories No. 10Vitapharma

  92 rub. order

• Bifidumbacterin sachets 5 doses No. 10Partner JSC

  102 RUR order

• Bifidumbacterin (vial 5 doses No. 10) Vitapharma

  93 RUR order

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Pharmacy24

• Bifidumbacterin No. 10 capsules TOV NVP Ariadna, Ukraine
  95 UAH.order
• Bifidumbacterin-Biopharma 5 doses No. 10 powder TOV"FZ "Biopharma", Ukraine

  122 UAH order

PaniPharmacy

• Bifidumbacterin capsule Bifidumbacterin caps. No. 10 Ukraine, Ariadna LLC

  118 UAH order

• Bifidumbacterin Bifidumbacterin dry. thing 5 doses No. 10 Ukraine, Biopharma CJSC

  149 UAH order

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