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Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis
Cornelius W Van Niel1, Chris Feudtner, Michelle M Garrison
1Sea Mar Community Health Center, Seattle, Washington 98108, USA. cvanniel@u.washington.edu
Insights
Lactobacillus probiotics significantly reduce diarrhea duration and frequency in children with acute infectious diarrhea. This meta-analysis confirms Lactobacillus as a safe and effective treatment option for pediatric gastroenteritis.
Area of Science:
- Pediatrics
- Microbiology
- Gastroenterology
Background:
- Childhood diarrhea is a major global health concern, causing significant illness and death.
- Oral Lactobacillus has shown potential antidiarrheal properties in previous studies.
- Acute infectious diarrhea in children requires effective and safe treatment strategies.
Purpose of the Study:
- To evaluate the efficacy of Lactobacillus treatment in improving clinical outcomes for children with acute infectious diarrhea.
- To conduct a meta-analysis of randomized, controlled trials assessing Lactobacillus's impact on diarrhea.
- To determine if Lactobacillus administration offers therapeutic benefits for pediatric diarrhea.
Main Methods:
- A comprehensive literature search was performed in biomedical and alternative medicine databases (1966-2000).
- Included were randomized, blinded, placebo-controlled trials reporting clinical outcomes of diarrhea intensity.
- Nine studies met the inclusion criteria; meta-analysis focused on diarrhea duration and frequency.
Main Results:
- Lactobacillus treatment reduced diarrhea duration by an average of 0.7 days.
- A reduction of 1.6 fewer stools on day 2 of treatment was observed with Lactobacillus.
- A potential dose-effect relationship for Lactobacillus was suggested in subanalyses.
Conclusions:
- Lactobacillus demonstrates safety and effectiveness in treating acute infectious diarrhea in children.
- The findings support the use of Lactobacillus as an adjunctive therapy for pediatric diarrhea.
- Further research may explore optimal dosing and specific strains for enhanced efficacy.
Objective:
Childhood diarrhea accounts for substantial morbidity and mortality worldwide. Multiple studies in children have shown that Lactobacillus, administered orally, may have antidiarrheal properties. We conducted a meta-analysis of randomized, controlled studies to assess whether treatment with Lactobacillus improves clinical outcomes in children with acute infectious diarrhea.
Methods:
Studies were sought in bibliographic databases of traditional biomedical as well as complementary and alternative medicine literature published from 1966 to 2000. Search terms were "competitive inhibition," "diarrhea," "gastroenteritis," "Lactobacillus," "probiotic," "rotavirus," and "yog(h)urt." We included studies that were adequately randomized, blinded, controlled trials in which the treatment group received Lactobacillus and the control group received an adequate placebo and that reported clinical outcome measures of diarrhea intensity. These inclusion criteria were applied by blind review and consensus. The original search yielded 26 studies, 9 of which met the criteria. Multiple observers independently extracted study characteristics and clinical outcomes. Data sufficient to perform meta-analysis of the effect of Lactobacillus on diarrhea duration and diarrhea frequency on day 2 were contained in 7 and 3 of the included studies, respectively.
Results:
Summary point estimates indicate a reduction in diarrhea duration of 0.7 days (95% confidence interval: 0.3-1.2 days) and a reduction in diarrhea frequency of 1.6 stools on day 2 of treatment (95% confidence interval: 0.7-2.6 fewer stools) in the participants who received Lactobacillus compared with those who received placebo. Details of treatment protocols varied among the studies. A preplanned subanalysis suggests a dose-effect relationship.
Conclusion:
The results of this meta-analysis suggest that Lactobacillus is safe and effective as a treatment for children with acute infectious diarrhea.