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Systematic review: Limosilactobacillus reuteri DSM 17938 for preventing antibiotic-associated diarrhoea in children

Hania Szajewska1, Maciej Kołodziej1, Bartłomiej M Zalewski1

  • 1Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.

Journal of Pediatric Gastroenterology and Nutrition
|January 4, 2026
PubMed
Abstract

Insights

Limosilactobacillus reuteri DSM 17938 may prevent antibiotic-associated diarrhea (AAD) in children when given for up to 21 days, especially with amoxicillin-clavulanate. Shorter durations or longer follow-up showed no significant benefit.

Area of Science:

  • Microbiology and Immunology
  • Pediatric Gastroenterology

Background:

  • Probiotic efficacy is strain-specific, requiring individual assessment.
  • Antibiotic-associated diarrhea (AAD) is a common concern in pediatric patients receiving systemic antibiotics.

Purpose of the Study:

  • To evaluate the effectiveness of Limosilactobacillus reuteri DSM 17938 in preventing AAD in children.
  • To analyze strain-specific probiotic effects in a pediatric population.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) from major databases and trial registries (January 2016-July 2025).
  • Included studies compared L. reuteri DSM 17938 with placebo, no treatment, or other probiotics in children.
  • Risk of bias and certainty of evidence were assessed using ROB-2 and GRADE criteria, respectively.

Main Results:

  • Three RCTs involving 1070 children were analyzed.
  • A 21-day regimen of L. reuteri DSM 17938 showed moderate certainty evidence for reducing AAD risk (RR: 0.50, 95% CI: 0.33-0.75).
  • A subgroup analysis indicated benefit for children receiving amoxicillin-clavulanate (RR: 0.49, 95% CI: 0.32-0.76).

Conclusions:

  • L. reuteri DSM 17938 may reduce AAD risk in children when administered for up to 21 days or with amoxicillin-clavulanate.
  • No significant benefit was observed with shorter administration periods or extended follow-up.
  • Further high-quality trials are recommended to support routine use.
Keywords:
meta‐analysisprobioticsrandomized controlled trials

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