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Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European
S Guandalini1, L Pensabene, M A Zikri
1Unitá di Pediatria, Università di Catanzaro, Italy.
Insights
Adding Lactobacillus GG to oral rehydration solution significantly shortens diarrhea duration in children. This probiotic intervention improves recovery and reduces hospital stays for acute diarrhea cases.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Infectious Diseases
Background:
- Probiotic Lactobacillus GG (LGG) is known to aid recovery from rotavirus-induced diarrhea.
- Limited data exists on LGG's efficacy in non-rotaviral diarrhea and when administered with oral rehydration solution (ORS).
Purpose of the Study:
- To evaluate the efficacy and safety of LGG when incorporated into ORS for treating acute-onset diarrhea in children.
Main Methods:
- A multicenter, double-blind, placebo-controlled trial enrolled children aged 1 month to 3 years with acute diarrhea.
- Participants received either ORS with placebo or ORS with live Lactobacillus GG (at least 10(10) CFU/250 ml).
- Post-rehydration, children received usual feedings plus the assigned solution until diarrhea resolved.
Main Results:
- The study included 140 children in the placebo group and 147 in the Lactobacillus GG group, with no significant baseline differences.
- Diarrhea duration was significantly shorter in the Lactobacillus GG group (58.3 hours) compared to placebo (71.9 hours) (P = 0.03).
- A lower percentage of children in the Lactobacillus GG group experienced diarrhea lasting over 7 days (2.7% vs. 10.7%), and hospital stays were shorter.
Conclusions:
- Administering oral rehydration solution with Lactobacillus GG is safe for children with acute diarrhea.
- LGG supplementation in ORS leads to a reduced duration of diarrhea and fewer prolonged cases.
- This probiotic approach facilitates faster hospital discharge for pediatric patients suffering from acute diarrhea.
Background:
The probiotic Lactobacillus GG is effective in promoting a more rapid recovery of acute, watery diarrhea in children with rotavirus enteritis. Very limited information is available, however, on the potential role of such agents in non-rotaviral diarrheal episodes. Furthermore, no evidence is available concerning the efficacy of Lactobacillus GG administered in the oral rehydration solution during oral rehydration therapy. A multicenter trial was conducted to evaluate the efficacy of Lactobacillus GG administered in the oral rehydration solution to patients with acute-onset diarrhea of all causes.
Methods:
Children 1 month to 3 years of age with acute-onset diarrhea were enrolled in a double-blind, placebo-controlled investigation. Patients were randomly allocated to group A, receiving oral rehydration solution plus placebo, or group B, receiving the same preparation but with a live preparation of Lactobacillus GG (at least 10(10) CFU/250 ml). After rehydration in the first 4 to 6 hours, patients were offered their usual feedings plus free access to the same solution until diarrhea stopped.
Results:
One hundred forty children were enrolled in group A, and 147 in group B. There were no differences at admission between the groups in age, sex, previous types of feeding, previous duration of diarrhea, use of antibiotics, weight, height, weight-height percentile, prevalence of fever, overall status, degree of dehydration, and percentage of in- versus outpatients. Duration of diarrhea after enrollment was 71.9 +/- 35.8 hours in group A versus 58.3 +/- 27.6 hours in group B (mean +/- SD; P = 0.03). In rotavirus-positive children, diarrhea lasted 76.6 +/- 41.6 hours in group A versus 56.2 +/- 16.9 hours in groups B (P < 0.008). Diarrhea lasted longer than 7 days in 10.7% of group A versus 2.7% of group B patients (P < 0.01). Hospital stays were significantly shorter in group B than in group A.
Conclusions:
Administering oral rehydration solution containing Lactobacillus GG to children with acute diarrhea is safe and results in shorter duration of diarrhea, less chance of a protracted course, and faster discharge from the hospital.
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