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Probiotics for treating acute infectious diarrhoea.

Shelui Collinson1, Andrew Deans2, April Padua-Zamora3

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Probiotics likely do not significantly reduce the duration of acute infectious diarrhea in children or adults. Evidence suggests little to no difference in diarrhea lasting 48 hours or more.

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Area of Science:

  • Gastroenterology
  • Microbiology
  • Evidence-Based Medicine

Background:

  • Acute infectious diarrhea is a common illness, particularly in children.
  • Probiotics are often used with the aim of reducing diarrhea duration.
  • The efficacy of probiotics for infectious diarrhea requires robust scientific evaluation.

Purpose of the Study:

  • To systematically assess the effectiveness of probiotics in treating acute infectious diarrhea.
  • To evaluate the impact of probiotics on diarrhea duration and related outcomes.
  • To synthesize evidence from randomized controlled trials (RCTs).

Main Methods:

  • Searched multiple databases (MEDLINE, Embase, Cochrane Library) up to December 2019.
  • Included RCTs comparing probiotics with placebo in acute infectious diarrhea.
  • Extracted data on diarrhea duration, hospitalization, and adverse events; assessed risk of bias.

Main Results:

  • Included 82 RCTs with over 12,000 participants, mostly children.
  • No significant difference in diarrhea lasting ≥ 48 hours (moderate-certainty evidence).
  • Uncertainty regarding reduction in overall diarrhea duration (very low-certainty evidence); heterogeneity was high.

Conclusions:

  • Probiotics likely have minimal to no effect on the duration of acute infectious diarrhea.
  • Evidence quality is limited by heterogeneity and risk of bias in many studies.
  • Further high-quality research is needed to clarify the role of specific probiotics.