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Efficacy of probiotic use in acute diarrhea in children: a meta-analysis
Jeannie S Huang1, Athos Bousvaros, John W Lee
1Children's Hospital, Boston, Massachusetts, USA.
Insights
Probiotic supplements can shorten the duration of acute diarrhea in children by about one day when used with standard rehydration. This finding supports probiotics as an effective supportive therapy for pediatric diarrheal illness.
Area of Science:
- Pediatrics
- Microbiology
- Gastroenterology
Background:
- Acute diarrheal illness is a common pediatric concern.
- Standard rehydration therapy is the cornerstone of treatment.
- Exploring adjunctive therapies to reduce illness duration is crucial.
Purpose of the Study:
- To evaluate the efficacy of probiotic use in reducing diarrhea duration in children.
- To synthesize evidence from multiple clinical trials through meta-analysis.
Main Methods:
- Meta-analysis of 18 eligible studies.
- Included trials focused on children under 5 years old with acute diarrhea.
- Primary outcome was the difference in diarrhea duration between probiotic and control groups.
Main Results:
- Probiotic coadministration with rehydration therapy reduced diarrhea duration by approximately 1 day (pooled estimate = -0.8 days).
- Results were consistent across analyses of hospitalized children, double-blinded trials, and studies using lactobacilli.
- Significant heterogeneity was observed between studies (Q statistic = 204.1, P < 0.001).
Conclusions:
- Bacterial probiotic therapy is an effective intervention to shorten the duration of acute diarrheal illness in children.
- Probiotics offer a valuable addition to standard rehydration protocols for pediatric diarrhea.
- Further research may explore specific probiotic strains and optimal treatment durations.
Abstract:
Our objective was to determine the efficacy of probiotic use in reducing the duration of increased stool output in children with acute diarrheal illness. Eligible studies were limited to trials of probiotic therapy in otherwise healthy children <5 years old with acute-onset diarrhea. The main outcome variable was difference in diarrhea duration between treatment and control groups. Our meta-analysis of 18 eligible studies suggests that coadministration of probiotics with standard rehydration therapy reduces the duration of acute diarrhea by approximately 1 day [random-effects pooled estimate = -0.8 days (-1.1, -0.6), P < 0.001]. Differences in treatment effect between studies was assessed by calculating the Q statistic (Q = 204. 1, P < 0.001). In subsequent analyses limited to studies of hospitalized children, to double-blinded trials, and to studies evaluating lactobacilli, the pooled estimates were similar (-0.6 to -1.2 days, P < 0.001). In conclusion, bacterial probiotic therapy shortens the duration of acute diarrheal illness in children by approximately one day.