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Bacteriotherapy with Lactobacillus reuteri in rotavirus gastroenteritis
A V Shornikova1, I A Casas, H Mykkänen
1University of Tampere Medical School, Finland.
Insights
Lactobacillus reuteri effectively treats rotavirus-associated diarrhea in children. This probiotic significantly reduced watery diarrhea duration and colonized the gut, with higher doses showing greater efficacy.
Area of Science:
- Microbiology
- Gastroenterology
- Pediatrics
Background:
- Certain lactic acid bacteria accelerate recovery from acute diarrhea.
- Lactobacillus reuteri is a common Lactobacillus species with therapeutic potential for diarrhea.
Purpose of the Study:
- To evaluate the efficacy of Lactobacillus reuteri in treating rotavirus-associated diarrhea in children.
- To assess the impact of L. reuteri dosage on diarrhea duration and gastrointestinal colonization.
Main Methods:
- Prospective, randomized, placebo-controlled trial involving children aged 6-36 months with rotavirus diarrhea.
- Participants received daily doses of either 10(10) or 10(7) colony-forming units (cfu) of L. reuteri or a placebo for up to 5 days.
Main Results:
- L. reuteri significantly shortened the duration of watery diarrhea compared to placebo (1.5-1.9 days vs. 2.5 days).
- Higher L. reuteri dosage showed a stronger correlation with reduced diarrhea duration and persistence.
- Stool cultures confirmed effective gastrointestinal colonization by L. reuteri, with higher counts in the treatment groups.
Conclusions:
- L. reuteri is effective in colonizing the GI tract and shortening watery diarrhea duration in rotavirus-associated cases.
- A dose-dependent relationship exists between L. reuteri administration and clinical improvement.
Background:
Certain lactic acid bacteria may accelerate recovery from acute diarrhea. Lactobacillus reuteri is a commonly occurring Lactobacillus species with therapeutic potential in diarrhea.
Design:
Prospective, randomized, placebo-controlled trial in two hospitals.
Methods:
Children between 6 and 36 months of age admitted for rotavirus-associated diarrhea were randomized into three groups to receive either 10(10) or 10(7) colony-forming units (cfu) of L. reuteri or a matching placebo once a day for up to 5 days.
Results:
The main effect of L. reuteri was on the duration of watery diarrhea. The mean (+/-SD) duration of watery diarrhea after initiation of treatment was 2.5 (1.5) days in the placebo group (n = 25) vs. 1.9 (0.9) days in the small dosage (n = 20) and 1.5 (1.1) days in the large dosage (n = 21) L. reuteri recipients (P = 0.01). By the second day of treatment watery diarrhea persisted in 80% of the placebo, 70% of the small dosage and 48% of the large dosage L. reuteri recipients (P = 0.04, large dosage vs. placebo). Stool cultures for lactobacilli confirmed that administration of L. reuteri resulted in good colonization of the GI tract. The mean (+/-SD) of total Lactobacillus count 2 days after treatment initiation was 2.8 (1.6) log 10 cfu/g in the placebo group, 4.5 (2.0) log 10 cfu/g in the small dosage L. reuteri group and 6.1 (1.2) log 10 cfu/g in the large dosage L. reuteri group (P = 0.0004).
Conclusions:
L. reuteri effectively colonized the gastrointestinal tract after administration and significantly shortened the duration of watery diarrhea associated with rotavirus. There was a correlation between the dosage of L. reuteri and the clinical effect.