Probiotic Bifidobacterium Breve PRL2020 in Oral Drops in Preventing Side Effects From Amoxicillin or Amoxicillin/Clavulanic Acid Antibiotic Use
Assessment of the Impact of an Amoxicillin/Clavulanic Acid-resistant Probiotic on the Reduction of AAD (Antibiotic-Associated Diarrhoea) in Children Treated With Amoxicillin/Clavulanic Acid or Amoxicillin: a Multicentre, Randomised, Placebo-controlled Clinical Trial.
This multicenter, randomized, double-blind, placebo-controlled clinical trial will evaluate the efficacy and safety of the probiotic Bifidobacterium breve PRL2020 (Brevicillin® gocce) in preventing gastrointestinal side effects associated with antibiotic therapy using amoxicillin or amoxicillin/clavulanic acid in pediatric patients aged 0-12 years. Participants will be randomized 1:1 to receive either the probiotic supplement or placebo during standard antibiotic treatment for 6-10 days, followed by a post-treatment observation period up to day 15 without probiotic or placebo administration. The primary objective is to assess the reduction in the incidence of antibiotic-associated diarrhea (AAD).
Aperçu de l'étude
Statut
Statut
Les conditions
Les conditions
Intervention / Traitement
Intervention / Traitement
Description détaillée
Antibiotic therapy with amoxicillin or amoxicillin/clavulanic acid is widely prescribed in pediatric populations but is frequently associated with gastrointestinal adverse effects, particularly diarrhea. These effects are linked to disruption of the gut microbiota and a reduction in bifidobacterial populations. Bifidobacterium breve PRL2020 is a probiotic strain with demonstrated intrinsic, non-transferable resistance to these antibiotics and has been developed to mitigate antibiotic-induced dysbiosis.
This study is a multicenter, prospective, randomized, double-blind, placebo-controlled, non-profit trial conducted in pediatric centers across Italy. The study aims to evaluate the clinical efficacy and safety of Bifidobacterium breve PRL2020 in reducing the incidence and severity of antibiotic-associated diarrhea (AAD) in children receiving amoxicillin or amoxicillin/clavulanic acid.
A total of 1024 participants will be enrolled. Participants will be randomized 1:1 to receive either Brevicillin® gocce (5 drops 2-3 times daily, containing 5 billion CFU of B. breve PRL2020 per dose) or matching placebo only during antibiotic therapy (6-10 days). After completion of antibiotic treatment, participants will enter a follow-up period until day 15 without probiotic or placebo administration.
The primary outcome is the incidence of AAD, defined as ≥3 diarrheal episodes in one day during antibiotic treatment (Bristol Stool Scale 5-7).
Secondary outcomes include the incidence and duration of diarrhea, daily bowel movements, stool consistency, gastrointestinal and extra-intestinal symptoms (such as nausea, vomiting, abdominal pain), treatment compliance, and adverse events.
Type d'étude
Type d'étude
Inscription (Estimé)
Inscription
Phase
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
Coordonnées de l'étude
- Nom: Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
Lieux d'étude
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Alessandria, Italie, 15121
- GROSSO CATERINA Studio medico - Spalto Marengo 92
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Alessandria, Italie, 15121
- VALARAUDI PIERA Studio medico - Via Galimberti 25
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Busto Arsizio, Italie, 21052
- MORGANTI GIANFRANCO Studio medico - Via Rossini Gioachino 9
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Frosinone, Italie, 03100
- MARIANI PAOLO Studio medico - VIA AMERICA LATINA 135
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Genova, Italie, 16129
- POGGI ELENA Studio medico - Via Montevideo 8
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Contact:
- Davide
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Messina, Italie, 98123
- BARBALACE ANDREA Studio medico - Via Nino Bixio 76
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Messina, Italie, 98123
- INFERRERA RAMONA Studio medico - Via Trieste 19
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Roma, Italie, 00156
- PACCHIAROTTI ALESSIA Studio medico - VIA FIUMINATA 4
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Torino, Italie, 10137
- ROVELLI ILARIA Studio medico - Via Baltimora 86
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Varese, Italie, 21100
- COLLI GIOVANNI studio medico privato - via Caracciolo 54
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Catanzaro
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Lamezia Terme, Catanzaro, Italie, 88046
- NERO ANNA MARIA Centro Salute Galattica - Via Giovanni Gronchi, 1
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Chieti
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Casoli, Chieti, Italie, 66043
- ANTONELLI LUCIETTA Studio medico - Vico Montaniera 27
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Como
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Cantù, Como, Italie, 22063
- OMETTO MARIANGELA studio pediatrico associato - via Al Monte 4
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Frosinone
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Anagni, Frosinone, Italie, 03012
- D'AVERSA IRENE Studio medico - VIALE REGINA MARGHERITA 7
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Anagni, Frosinone, Italie, 03012
- NOTO CRISTIAN Studio medico - VIA TARTARALTA DI SOTTO 25
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Padova
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Piazzola sul Brenta, Padova, Italie, 35016
- NARDINI FLAVIA studio medico - Via Portico della Tessitura 3/1
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Palermo
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Bagheria, Palermo, Italie
- MANCUSO GIUSEPPINA Studio medico - Via De Spuches 14
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Perugia
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Bastia umbra, Perugia, Italie, 06083
- RASTELLI STEFANIA studio medico - Via Foligno 23
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Foligno, Perugia, Italie, 06034
- CAMPUS MARIA GIULIA studio medico - Via Aspromonte SNC
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Venezia
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Mira, Venezia, Italie, 30034
- SATARIANO IRENE studio medico - Largo S.Luca 2
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Contact:
- Davide Sisti, PhD
- Numéro de téléphone: +39 0722 303301
- E-mail: davide.sisti@uniurb.it
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Critères de participation
Critère d'éligibilité
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Patients of either sex
- Age ≤ 12 years
- Requirement to undergo antibiotic treatment with amoxicillin or amoxicillin/clavulanic acid
Exclusion Criteria:
- Use of antibiotic therapy in the 4 weeks prior to enrolment in the study.
- Use of other probiotic products or products containing lactic acid bacteria during the study period.
- Presence of pre-existing diarrhoea in the 4 weeks prior to enrolment.
- Presence of chronic inflammatory bowel disease.
- Presence of immunodeficiency.
- Failure to obtain informed consent from the parent or legal guardian for participation in the study.
- Known allergy to the excipients in the formulation
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Quadruple
Nombre de bras
Armes et Interventions
Groupe de participants / BrasGroupe de participants / Bras |
Intervention / TraitementIntervention / Traitement |
|---|---|
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Expérimental: Brevicillin® gocce (Bifidobacterium breve PRL2020)
Participants will receive Brevicillin® gocce, a probiotic food supplement containing Bifidobacterium breve PRL2020 (LMG S-32458), alongside standard antibiotic therapy with amoxicillin or amoxicillin/clavulanic acid. Dosage and administration: 5 drops, 2-3 times per day (depending on antibiotic dosing schedule), administered during the antibiotic treatment period (6-10 days). After completion of antibiotic therapy, participants will enter a follow-up period until day 15 without probiotic administration. |
Brevicillin® gocce is a probiotic dietary supplement in oily drops containing the bacterial strain Bifidobacterium breve PRL2020 (LMG S-32458). Each 5-drop dose contains approximately 5 billion live cells. The supplement is administered orally 2-3 times per day, in parallel with antibiotic therapy (amoxicillin or amoxicillin/clavulanic acid), for 6-10 days only (during the antibiotic course). After completion of antibiotic therapy, participants enter a follow-up period until day 15 without probiotic administration. The product is manufactured by PharmExtracta S.p.A., Pontenure, Italy. |
|
Comparateur placebo: Placebo
Participants will receive a placebo formulation matched in appearance, packaging, and dosing schedule to Brevicillin® gocce, administered alongside standard antibiotic therapy with amoxicillin or amoxicillin/clavulanic acid. The placebo will be given at the same frequency (5 drops, 2-3 times per day) and duration as the experimental product during the antibiotic treatment period (6-10 days). After antibiotic completion, participants will enter a follow-up period until day 15 without placebo administration. |
The placebo is a formulation identical in appearance, packaging, and administration schedule to Brevicillin® gocce but without the Bifidobacterium breve PRL2020 strain. It is administered orally 2-3 times per day only during the antibiotic treatment period (6-10 days). After antibiotic completion, participants enter a follow-up period until day 15 without placebo administration. |
Que mesure l'étude ?
Principaux critères de jugement
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Incidence of Antibiotic-Associated Diarrhea (AAD)
Délai: 15 days
|
Evaluation of the efficacy of Bifidobacterium breve PRL2020 (Brevicillin® gocce) in reducing the incidence of antibiotic-associated diarrhea (AAD), defined as ≥3 diarrheal episodes within one day of antibiotic treatment, with stool consistency corresponding to types 5-7 on the Bristol Stool Scale. Data will be collected through a daily diary completed by the parent or legal guardian. |
15 days
|
Mesures de résultats secondaires
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Incidence of children with at least one episode of diarrhea
Délai: 15 days
|
Number of participants experiencing at least one episode of diarrhea during the study period, as recorded in the daily diary. |
15 days
|
|
Number of daily defecations
Délai: 15 days
|
Average number of daily bowel movements recorded by the parent or guardian during the study period, using the child's daily diary. |
15 days
|
|
Number of days with diarrhea
Délai: 15 days
|
Total number of days in which diarrhea occurs during the observation period, recorded by the parent or guardian. |
15 days
|
|
Stool consistency
Délai: 15 days
|
Assessment of stool consistency using the Bristol Stool Scale (BSS) to evaluate changes in bowel habits during and after antibiotic treatment. |
15 days
|
|
Abdominal pain During and After Antibiotic Treatment
Délai: 15 days
|
Assessment of abdominal pain related to antibiotic use, as recorded in daily diary entries completed by the parent or guardian. |
15 days
|
|
Nausea During and After Antibiotic Treatment
Délai: 15 days
|
Assessment of nausea related to antibiotic use, as recorded in daily diary entries completed by the parent or guardian. |
15 days
|
|
Vomiting During and After Antibiotic Treatment
Délai: 15 days
|
Assessment of vomiting related to antibiotic use, as recorded in daily diary entries completed by the parent or guardian. |
15 days
|
|
Treatment compliance
Délai: 15 days
|
Assessment of adherence to the probiotic or placebo regimen, graded by the pediatrician on a scale from "poor" to "excellent" at the end of the study period. |
15 days
|
|
Adverse events
Délai: 15 days
|
Documentation and evaluation of any adverse events reported during treatment and follow-up, as recorded in the child's daily diary and verified by the study physician. |
15 days
|
Collaborateurs et enquêteurs
Parrainer
Parrainer
Collaborateurs
Collaborateurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Début de l'étude
Achèvement primaire (Estimé)
Achèvement primaire
Achèvement de l'étude (Estimé)
Achèvement de l'étude
Dates d'inscription aux études
Première soumission
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Première publication
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour publiée
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Dernière vérification
Plus d'information
Termes liés à cette étude
Autres numéros d'identification d'étude
Autres numéros d'identification d'étude
- 188_2ottobre2026_DROPS AAD_Sis
Informations sur les médicaments et les dispositifs, documents d'étude
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