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).
Studieöversikt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljerad beskrivning
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.
Studietyp
Studietyp
Inskrivning (Beräknad)
Inskrivning
Fas
Fas
- Inte tillämpbar
Kontakter och platser
Studiekontakt
Studiekontakt
- Namn: Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
Studieorter
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Alessandria, Italien, 15121
- GROSSO CATERINA Studio medico - Spalto Marengo 92
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Alessandria, Italien, 15121
- VALARAUDI PIERA Studio medico - Via Galimberti 25
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Busto Arsizio, Italien, 21052
- MORGANTI GIANFRANCO Studio medico - Via Rossini Gioachino 9
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Frosinone, Italien, 03100
- MARIANI PAOLO Studio medico - VIA AMERICA LATINA 135
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Genova, Italien, 16129
- POGGI ELENA Studio medico - Via Montevideo 8
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Kontakt:
- Davide
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Messina, Italien, 98123
- BARBALACE ANDREA Studio medico - Via Nino Bixio 76
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Messina, Italien, 98123
- INFERRERA RAMONA Studio medico - Via Trieste 19
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Roma, Italien, 00156
- PACCHIAROTTI ALESSIA Studio medico - VIA FIUMINATA 4
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Torino, Italien, 10137
- ROVELLI ILARIA Studio medico - Via Baltimora 86
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Varese, Italien, 21100
- COLLI GIOVANNI studio medico privato - via Caracciolo 54
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Catanzaro
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Lamezia Terme, Catanzaro, Italien, 88046
- NERO ANNA MARIA Centro Salute Galattica - Via Giovanni Gronchi, 1
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Chieti
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Casoli, Chieti, Italien, 66043
- ANTONELLI LUCIETTA Studio medico - Vico Montaniera 27
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Como
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Cantù, Como, Italien, 22063
- OMETTO MARIANGELA studio pediatrico associato - via Al Monte 4
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Frosinone
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Anagni, Frosinone, Italien, 03012
- D'AVERSA IRENE Studio medico - VIALE REGINA MARGHERITA 7
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Anagni, Frosinone, Italien, 03012
- NOTO CRISTIAN Studio medico - VIA TARTARALTA DI SOTTO 25
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Padova
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Piazzola sul Brenta, Padova, Italien, 35016
- NARDINI FLAVIA studio medico - Via Portico della Tessitura 3/1
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Palermo
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Bagheria, Palermo, Italien
- MANCUSO GIUSEPPINA Studio medico - Via De Spuches 14
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Perugia
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Bastia umbra, Perugia, Italien, 06083
- RASTELLI STEFANIA studio medico - Via Foligno 23
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Foligno, Perugia, Italien, 06034
- CAMPUS MARIA GIULIA studio medico - Via Aspromonte SNC
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Venezia
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Mira, Venezia, Italien, 30034
- SATARIANO IRENE studio medico - Largo S.Luca 2
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Kontakt:
- Davide Sisti, PhD
- Telefonnummer: +39 0722 303301
- E-post: davide.sisti@uniurb.it
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Deltagandekriterier
Urvalskriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
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
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Förebyggande
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Fyrdubbla
Antal vapen
Vapen och interventioner
Deltagargrupp / ArmDeltagargrupp / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Experimentell: 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. |
|
Placebo-jämförare: 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. |
Vad mäter studien?
Primära resultatmått
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Incidence of Antibiotic-Associated Diarrhea (AAD)
Tidsram: 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
|
Sekundära resultatmått
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Incidence of children with at least one episode of diarrhea
Tidsram: 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
Tidsram: 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
Tidsram: 15 days
|
Total number of days in which diarrhea occurs during the observation period, recorded by the parent or guardian. |
15 days
|
|
Stool consistency
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
Tidsram: 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
|
Samarbetspartners och utredare
Sponsor
Sponsor
Samarbetspartners
Samarbetspartners
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Studiestart
Primärt slutförande (Beräknad)
Primärt slutförande
Avslutad studie (Beräknad)
Avslutad studie
Studieregistreringsdatum
Först inskickad
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Första postat
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste uppdatering publicerad
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Senast verifierad
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