Effects of Probiotics and/or Prebiotics on the Duration of Diarrhea and Hospitalization in Children
Condition: Acute Diarrhea
MeSH terms: Diarrhea
Study type: Interventional
Phase: Phase 4

Summary: 
      -  Acute diarrhea continues to be a major cause of childhood morbidity and mortality in
           developed and developing countries.

        -  Prevention and treatment of dehydration are the mainstays of therapy. Rehydration can be
           achieved with oral rehydratation solution (ORS).

        -  Even though ORS has reduced the mortality and morbidity very significantly, it has no
           effect on the duration of diarrhea, stool consistency and frequency and remains
           underused.

        -  ESPGHAN and ESPID published together an evidence based guideline and stated that in the
           management of acute gastroenteritis rehydration is the key treatment and that selected
           probiotics may reduce the duration and intensity of symptoms and can be used as an
           adjuvant to ORS.

        -  Current evidence also indicates that probiotic effects are strain-specific.
           Lactobacillus GG and Saccharomyces boulardii are the best studied strains. However, more
           research is needed to guide the use of particular probiotic regimens and strains and as
           there is still no evidence of efficacy for many preparations.
    

Detailed description: 
      Acute diarrhea continues to be a major cause of childhood morbidity and mortality in
      developed and developing countries. Prevention and treatment of dehydration are the mainstays
      of therapy. Rehydration can be achieved with oral rehydratation solution (ORS). Even though
      ORS has reduced the mortality and morbidity very significantly, it has no effect on the
      duration of diarrhea, stool consistency and frequency and remains underused. ESPGHAN and
      ESPID published together an evidence based guideline and stated that in the management of
      acute gastroenteritis rehydration is the key treatment and that selected probiotics may
      reduce the duration and intensity of symptoms and can be used as an adjuvant to ORS. A recent
      Cochrane review including 56 trials in children concluded that speciﬁc probiotics reduce the
      duration of diarrhea with about 24 hours and decrease the frequency of defecation on the
      second day. Current evidence also indicates that probiotic effects are strain-specific.
      Lactobacillus LGG and Saccharomyces boulardii are the best studied strains. However, more
      research is needed to guide the use of particular probiotic regimens and strains and as there
      is still no evidence of efficacy for many preparations. The aim of this study was to evaluate
      effects of different probiotics on the duration of acute infectious diarrhea.
    

Intervention name(s): Probiotic; ORS
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): Comparison of probiotics vs. ORS; ORS ad libitum
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: probiotics, diarrhea