Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Use of Probiotics to Prevent Cholangitis in Children With Biliary Atresia
Brief Summary: Abstract

Biliary atresia (BA) is an idiopathic, progressive, and fatal disease if untreated. Since Kasai first introduced the operation for BA in 1959, there have been encouraging results in treating this disease. Ascending cholangitis is a frequent and often recurrent complication. It may worsen the prognosis, with an increase in mortality, secondary failure of restoration of bile flow, and possible exacerbation of portal hypertension. For patients who have had restoration of bile flow with a timely portoenterostomy, the recurrence of ascending cholangitis is the single most significant variable pertaining to long-term prognosis. Patients with multiple episodes of ascending cholangitis are more likely to require liver transplantation than those without multiple recurrences. Therefore, the prevention of cholangitis is crucial in the management of patients who have had a Kasai portoenterostomy.

Some oral antibiotics, like trimethoprim-sulfamethoxazole (TMP/SMZ) and neomycin have showed the effect to prevent against ascending cholangitis. But, we should consider the problem of drug resistance after long-term use of antibiotics. Is there any better and safer treatment? Probiotics are live microorganisms, which have beneficial effects on human health. Many studies have showed that probiotics have effects to treat or prevent intestinal infection or inflammation even for patient after liver transplantation. The aim of this study is to investigate the possibility of use of probiotics in prophylaxis of ascending cholangitis.

We want to enroll 20 BA patients aged 0 to 3 years, who had a Kasai operation. Ten patients are treated with neomycin (25 mg/kg/d, qid, 4 days a week). Another 10 patients receive Lactobacillus casei rhamnosus, Lcr 35 (8x108 CFU/day, bid) The duration of treatment is 6 months. Bacterial cultures of stool are performed before treatment and 1 month, 3 months and 6 months after treatment to evaluate the change of intestinal flora. Another 10 BA patients, from 1991 to 1996, aged 0 to 3 years, without prophylaxis after portoenterostomy, were served as the historical control group. Comparisons of the episodes of cholangitis, time to the first episode, and body weight change are made among the three groups.


Options:
A: Arm Label: Lepicol probiotic & prebiotic formula+simple lifestyle advice; Type: ACTIVE_COMPARATOR; Interventions: Drug: Lepicol probiotic & prebiotic formula, Other: Simple lifestyle advice | Arm Label: Simple lifestyle advice alone; Type: PLACEBO_COMPARATOR; Interventions: Other: Simple lifestyle advice | Intervention Type: DRUG; Name: Lepicol probiotic & prebiotic formula; Assigned to Arm(s): Lepicol probiotic & prebiotic formula+simple lifestyle advice | Intervention Type: OTHER; Name: Simple lifestyle advice; Assigned to Arm(s): Lepicol probiotic & prebiotic formula+simple lifestyle advice, Simple lifestyle advice alone
B: Arm Label: alcohol, hepatitis, Placebo; Type: PLACEBO_COMPARATOR; Interventions: Drug: alcohol, hepatitis, Placebo | Arm Label: hepatitis, alcohol, probiotics; Type: ACTIVE_COMPARATOR; Interventions: Drug: hepatitis, alcohol, probiotics | Intervention Type: DRUG; Name: hepatitis, alcohol, probiotics; Assigned to Arm(s): hepatitis, alcohol, probiotics | Intervention Type: DRUG; Name: alcohol, hepatitis, Placebo; Assigned to Arm(s): alcohol, hepatitis, Placebo
C: Arm Label: Neomycin prescribed; Type: EXPERIMENTAL; Interventions: Drug: Neomycin | Arm Label: Probiotics (Lactobacillus casei rhamnosus, Lcr35) prescribed; Type: EXPERIMENTAL; Interventions: Drug: Lactobacillus casei rhamnosus (Lcr35) | Arm Label: control; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: DRUG; Name: Lactobacillus casei rhamnosus (Lcr35); Assigned to Arm(s): Probiotics (Lactobacillus casei rhamnosus, Lcr35) prescribed | Intervention Type: DRUG; Name: Neomycin; Assigned to Arm(s): Neomycin prescribed
D: Arm Label: Synbiotic; Type: ACTIVE_COMPARATOR; Interventions: Dietary Supplement: synbiotic | Arm Label: maltodexterin; Type: PLACEBO_COMPARATOR; Interventions: Other: placebo | Intervention Type: DIETARY_SUPPLEMENT; Name: synbiotic; Assigned to Arm(s): Synbiotic | Intervention Type: OTHER; Name: placebo; Assigned to Arm(s): maltodexterin

Answer: C