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Probiotics for treating persistent diarrhoea in children
Guillermo Bernaola Aponte1, Carlos Alfonso Bada Mancilla, Nilton Yhuri Carreazo Pariasca
1Suárez Angamos Hospital, Angamos Este Avenue 261, Miraflores, Lima, Peru, 18.
Insights
Probiotics may effectively reduce the duration of persistent diarrhea in children. This systematic review found limited evidence, but no adverse events were reported in the analyzed trials.
Area of Science:
- Pediatrics
- Gastroenterology
- Microbiology
Background:
- Persistent diarrhea causes a significant proportion of diarrhea-related deaths in developing countries.
- Probiotics are being explored as a potential treatment for persistent diarrhea.
Purpose of the Study:
- To evaluate the efficacy of probiotics in treating persistent diarrhea in children.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
- Searches included major databases (Cochrane, MEDLINE, EMBASE, LILACS) and trialist contact.
- Two reviewers assessed eligibility, risk of bias, and extracted data; fixed-effect model was used for analysis.
Main Results:
- Four RCTs with 464 participants were included; one had a low risk of bias.
- Meta-analysis indicated probiotics reduced persistent diarrhea duration by an average of 4.02 days (95% CI: 3.43 to 4.61).
- Probiotics also reduced stool frequency and potentially hospital stay, with no reported adverse events.
Conclusions:
- Limited evidence suggests probiotics may be effective for treating persistent diarrhea in children.
- Further high-quality research is warranted to confirm these findings.
Background:
Persistent diarrhoea (diarrhoea lasting more than 14 days) accounts for one third of all diarrhoea related deaths in developing countries in some studies. Probiotics may help treatment.
Objectives:
To evaluate probiotics for treating persistent diarrhoea in children.
Search Strategy:
In August 2010, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, and LILACS. We also contacted authors of included trials and organizations working in the field, and checked reference lists.
Selection Criteria:
Randomized controlled trials comparing a specified probiotic agent with placebo or no probiotic in children with persistent diarrhoea.
Data Collection And Analysis:
Two review authors assessed the eligibility, risk of bias, extracted and analysed data. Differences were resolved by discussion. Statistical analysis were performed using the fixed-effect model and the results were expressed as mean difference (MD) for continuous outcomes with 95% confidence intervals (CI).
Main Results:
Four trials were included, with a total number of 464 participants; one trial had a low risk of bias. Meta-analysis showed that probiotics reduced the duration of persistent diarrhoea (mean difference 4.02 days, 95% CI 4.61 to 3.43 days, n=324, 2 trials). Stool frequency was reduced with probiotics in two trials. One trial reported a shorter hospital stay, which was significant, but numbers were small. No adverse events were reported.
Authors' Conclusions:
There is limited evidence suggesting probiotics may be effective in treating persistent diarrhoea in children.
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