The effectiveness of the synbiotic Maxilac<sup>®</sup> for the new coronavirus infection after antibacterial therapy

The new coronavirus infection (COVID-19) that emerged in 2019 is a infection caused by the SARS-CoV-2 virus. Although SARS-CoV-2 predominantly affects the respiratory system, numerous studies suggest significant gastrointestinal involvement in COVID-19, particularly in children. Aim. To evaluate the effect of the synbiotic Maxilac® in children with COVID-19 after antibacterial therapy (ABT). Materials and methods. A clinical post-approval open-label observational prospective single-center study with minimal intervention was conducted. The microbiome of children with COVID-19 was studied. Twelve children with COVID-19 complicated by a bacterial infection (pneumonia, sinusitis, otitis) were included, receiving ABT and then taking the synbiotic Maxilac® for 4 weeks. Patient data were collected: symptoms, medical history, clinical status, study of intestinal microbiota (IM) by 16S sequencing, stool test for zonulin, and review of drug therapy. The material was sampled in patients with COVID-19 at 3 time points: at the time of acute COVID-19 disease, at the time of recovery from COVID-19, and 4 weeks after starting the synbiotic therapy. Results. The administration of the synbiotic Maxilac® to patients who received ABT for bacterial complications of COVID-19 relieves clinical gastroenterological symptoms, prevents the development of dysbiosis, and normalizes intestinal permeability. The results indicated significant changes in IM after ABT in complicated COVID-19 and the normalizing effect of synbiotic Maxilac® on IM during administration for 30 days. The synbiotic Maxilac® in the group of children with COVID-19 who received ABT had no side effects and was safe. Conclusion. Children with COVID-19, complicated by a bacterial infection, treated with ABT are recommended to receive the synbiotic Maxilac® for at least 30 days after recovery.