Related Experiment Video
Updated: Oct 8, 2025
Probiotic Studies in Neonatal Mice Using Gavage
Published on: January 27, 2019
Which Probiotic Is the Most Effective for Treating Acute Diarrhea in Children? A Bayesian Network Meta-Analysis of
Zengbin Li1, Guixian Zhu1, Chao Li2
1China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi'an 710061, China.
Insights
Saccharomyces boulardii is the most effective probiotic for reducing acute diarrhea duration and risk in children under five. Several other single- and multi-strain probiotics also show significant benefits compared to placebo.
Area of Science:
- Pediatrics
- Gastroenterology
- Microbiology
Background:
- Acute diarrhea is a leading cause of illness and death in young children globally.
- Probiotics show promise for treating acute diarrhea, but comparative effectiveness is unclear.
- Identifying the most effective probiotic strain is crucial for clinical practice.
Purpose of the Study:
- To conduct a Bayesian network meta-analysis comparing the effectiveness of various probiotics for acute diarrhea in children.
- To evaluate the impact of probiotics on diarrhea duration and the risk of prolonged diarrhea (≥2 days).
- To assess secondary outcomes including stool frequency, hospitalization, fever, and vomiting.
Main Methods:
- Systematic search of EMBASE, PubMed, and Cochrane Library for randomized clinical trials (RCTs) up to March 31, 2021.
- Inclusion of 84 studies involving 13,443 children and 21 different probiotic interventions.
- Bayesian network meta-analysis to compare probiotic efficacy, with evidence certainty assessed by GRADE guidelines.
Main Results:
- Moderate evidence shows Lactobacillus reuteri, Bifidobacterium lactis, Saccharomyces boulardii, and specific multi-strain combinations significantly reduce diarrhea duration.
- Saccharomyces boulardii and Lactobacillus reuteri significantly reduce the risk of diarrhea lasting ≥2 days, with moderate evidence.
- Saccharomyces boulardii demonstrated the greatest effectiveness in reducing both diarrhea duration and the risk of prolonged diarrhea.
Conclusions:
- Saccharomyces boulardii emerges as the most effective probiotic for treating acute diarrhea in children.
- Several other single-strain and multi-strain probiotics also offer significant therapeutic benefits.
- Further research may confirm the optimal probiotic strategies for pediatric acute diarrhea management.
Abstract:
Acute diarrhea is a major cause of morbidity and mortality in children under five. Probiotics are beneficial for treating acute diarrhea in children, but unclear which specific probiotic is the most effective. We performed a Bayesian network meta-analysis to examine the comparative effectiveness of probiotics. By searching EMBASE, PubMed, and the Cochrane Library up to 31 March 2021, randomized clinical trials (RCTs) on probiotics for treating acute diarrhea in children were included. Primary outcomes included the duration of diarrhea and diarrhea lasting ≥2 days, and secondary outcomes included the mean stool frequency on day 2 and duration of hospitalization, fever, and vomiting. We assessed the certainty of the evidence of outcomes according to Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guideline. Eighty-four studies with twenty-one different interventions in 13,443 children were included. For the primary outcomes, moderate evidence indicated that, Lactobacillus reuteri [mean difference (MD) = -0.84 day; 95% confidence interval (CI), -1.39, -0.29], Bifidobacterium lactis (MD = -0.98 day; 95%CI, -1.82, -0.14), Saccharomyces boulardii (MD = -1.25 day; 95%CI, -1.59, -0.91), Lactobacillus species (spp.) plus Bifidobacterium spp. plus Saccharomyces spp. (MD = -1.19 day; 95%CI, -1.81, -0.58), and Bacillus spp. plus Enterococcus spp. plus Clostridium spp. (MD = -1.1 day; 95%CI, -1.84, -0.35) significantly reduced the duration of diarrhea when compared with placebo. Saccharomyces boulardii [Odds ratio (OR) = 0.22; 95%CI, 0.11, 0.41] and Lactobacillus reuteri (OR = 0.23; 95%CI, 0.090, 0.60) significantly reduced the risk of diarrhea lasting ≥2 days when compared with placebo or no treatment, with moderate evidence. Among all probiotics, Saccharomyces boulardii may be the most effective in reducing both duration of diarrhea (compared with placebo) and risk of diarrhea lasting ≥2 days (compared with placebo or no treatment), with moderate evidence. To be conclusive, Saccharomyces boulardii may be the most effective probiotic for treating acute diarrhea in children, followed by several other single-strain and multi-strain probiotics.
More Related Videos
08:34Investigating the Alleviating Effects of Bacillus cereus Administration on Colitis through Gut Microbiota Modulation
Published on: July 27, 2022
08:33Quantitative Polymerase Chain Reaction-based Analyses of Murine Intestinal Microbiota After Oral Antibiotic Treatment
Published on: November 17, 2018
Related Concept Videos
01:18Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
01:17Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
01:20Drugs Affecting GI Tract Motility: Adsorbents as Antidiarrheal Agents
Adsorbents...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...