Acceptability and efficacy of low-dose zinc with or without probiotics in acute watery diarrhoea-a prospective...

Acute watery diarrhoea (AWD) has not been well-treated with 20 mg elemental zinc, primarily because of adverse symptoms like vomiting. In contrast to 20 mg of zinc, this study sought to determine whether a lower dose of zinc, with or without probiotics, is as beneficial as 20 mg of zinc, yet tolerated better. The aim of this study was to compare the acceptability and efficacy of low-dose zinc (10 mg) with or without probiotics to the acceptability and efficacy of standard-dose zinc (20 mg) in children diagnosed with AWD. A prospective comparative study was conducted among children aged 6 months to 5 years with AWD at a tertiary healthcare centre. Eligible children were randomized into three groups: Group Z20 and Z10 were administered zinc acetate 20 mg/day and 10 mg/day, respectively, and Group Z10P with 10 mg/day with probiotics. Caregivers were followed daily via telephonic interviews for 14 days to record symptoms, adverse reactions, and treatment completion. Data were analyzed using Kruskal-Wallis test, one-way ANOVA, and the chi-square test. A total of 147 children were enrolled (49 in each group). The mean duration of AWD at enrollment was 3 ± 1.5 days, and the mean frequency was 5 ± 2 episodes/day. There was no significant difference in the mean duration of diarrhoea among the groups. The most common adverse reactions reported was vomiting (85%). Diarrhoea resolved within 3 days in 22.4% of Group Z10P, 10.2% of Group Z20, and 2% of Group Z10 (P = .03). Low-dose zinc (10 mg/day) was less effective than 20 mg zinc in controlling AWD. However, the combination of 10 mg zinc with probiotics significantly improved efficacy.