caa a22 4500 445342420 CHVBK 20180317142817.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1007/s00436-010-2095-4 doi (NATIONALLICENCE)springer-10.1007/s00436-010-2095-4 Clinical efficacy of Saccharomyces boulardii or metronidazole in symptomatic children with Blastocystis hominis infection [Elektronische Daten] [Ener Dinleyici, Makbule Eren, Nihal Dogan, Serap Reyhanioglu, Zeynel Yargic, Yvan Vandenplas] Although many Blastocystis infections remain asymptomatic, recent data suggest it also causes frequent symptoms. Therapy should be limited to patients with persistent symptoms and a complete workup for alternative etiologies. The goal of this study was to compare the natural evolution (no treatment) to the efficacy of Saccharomyces boulardii (S. boulardii) or metronidazole for the duration of diarrhea and the duration of colonization in children with gastrointestinal symptoms and positive stool examination for Blastocystis hominis. This randomized single-blinded clinical trial included children presenting with gastrointestinal symptoms (abdominal pain, diarrhea, nausea-vomiting, flatulence) more than 2weeks and confirmed B. hominis by stool examination (B. hominis cysts in the stool with microscopic examination of the fresh stool). The primary end points were clinical evaluation and result of microscopic stool examination at day15. Secondary end points were the same end points at day30. Randomization was performed by alternating inclusion: group A, S. boulardii (250mg twice a day, Reflor®) during 10days; group B, metronidazole (30mg/kg twice daily) for 10days; group C, no treatment. At day15 and 30 after inclusion, the patients were re-evaluated, and stool samples were examined microscopically. On day15, children that were still symptomatic and/or were still B. hominis-infected in group C were treated with metronidazole for 10days. There was no statistically significant difference between the three study groups for age, gender, and the presence of diarrhea and abdominal pain. On day15, clinical cure was observed in 77.7% in group A (n, 18); in 66.6% in group B (n, 15); and 40% in group C (n:15) (p < 0.031, between groups A and C). Disappearance of the cysts from the stools on day15 was 80% in group B, 72.2% in group A, and 26.6% in group C (p = 0.011, between group B and group C; p = 0.013, between group A and group C). At the end of the first month after inclusion, clinical cure rate was 94.4% in group A and 73.3% in group B (p = 0.11). Parasitological cure rate for B. hominis was very comparable between both groups (94.4% vs. 93.3%, p = 0.43). Metronidazole or S. boulardii has potential beneficial effects in B. hominis infection (symptoms, presence of parasites). These findings challenge the actual guidelines. Springer-Verlag, 2010 Dinleyici Ener Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey aut Eren Makbule Department of Pediatrics, Division of Pediatric Gastroenterology and Hepatology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey aut Dogan Nihal Department of Parasitology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey aut Reyhanioglu Serap Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey aut Yargic Zeynel Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey aut Vandenplas Yvan Universitair Ziekenhuis Brussel Kinderen, Vrije Universiteit Brussel, Brussels, Belgium aut Parasitology Research Springer-Verlag 108/3(2011-03-01), 541-545 0932-0113 108:3<541 2011 108 436 https://doi.org/10.1007/s00436-010-2095-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00436-010-2095-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Dinleyici Ener Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey aut NATIONALLICENCE 700 1- Eren Makbule Department of Pediatrics, Division of Pediatric Gastroenterology and Hepatology, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey aut NATIONALLICENCE 700 1- Dogan Nihal Department of Parasitology, Eskisehir Osmangazi University, Faculty of Medicine, Eskisehir, Turkey aut NATIONALLICENCE 700 1- Reyhanioglu Serap Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey aut NATIONALLICENCE 700 1- Yargic Zeynel Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey aut NATIONALLICENCE 700 1- Vandenplas Yvan Universitair Ziekenhuis Brussel Kinderen, Vrije Universiteit Brussel, Brussels, Belgium aut NATIONALLICENCE 773 0- Parasitology Research Springer-Verlag 108/3(2011-03-01), 541-545 0932-0113 108:3<541 2011 108 436 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer