A Double Blind Randomized Trial Showing Probiotics to Be Ineffective in Acute Diarrhea in Indonesian Children

Overview

Journal Indian J Pediatr

Specialty Pediatrics

Date 2014 Apr 30

PMID 24777621

Citations 10

Authors

Badriul Hegar

I Made Indra Waspada

Hartono Gunardi

Yvan Vandenplas

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the efficacy of probiotics added to oral rehydration solution and zinc in the treatment of acute infectious diarrhea in Indonesian children.

Methods: A prospective randomized double blind placebo-controlled trial was performed to test the efficacy of a probiotic food supplement in 112 children in the Kenari subdistrict, central Jakarta, aged 6-36 mo with acute infectious diarrhea and moderate dehydration. The supplemented group was given standard therapy (oral rehydration solution and zinc) and the probiotic strains Lactobacillus (L.) rhamnosus R0011 1.9 × 10(9) colony forming units (cfu) and L. acidophilus R0052 0.1 × 10(9) cfu/d for 7 d, while the control group was given standard therapy and placebo.

Results: Median duration of diarrhea was 68.5 h (range 13-165) in the supplemented and 61.5 h (range 21-166) in the control group (P = 0.596). Median daily frequency of defecation until diarrhea stopped was 5.0 in the supplemented vs. 5.5 in the control group (P = 0.795).

Conclusions: This probiotic food supplement tested did not reduce the duration of acute infectious diarrhea as compared to oral rehydration and zinc.

Citing Articles

A Systematic Review and Meta-Analysis: for Treating Acute Gastroenteritis in Children.

Cheng H, Ma Y, Liu X, Tian C, Zhong X, Zhao L Nutrients. 2022; 14(3).

PMID: 35277042 PMC: 8839062. DOI: 10.3390/nu14030682.

Efficacy of probiotics in the treatment of acute diarrhea in children: a systematic review and meta-analysis of clinical trials.

Huang R, Xing H, Liu H, Chen Z, Tang B Transl Pediatr. 2022; 10(12):3248-3260.

PMID: 35070839 PMC: 8753473. DOI: 10.21037/tp-21-511.

Which Probiotic Is the Most Effective for Treating Acute Diarrhea in Children? A Bayesian Network Meta-Analysis of Randomized Controlled Trials.

Li Z, Zhu G, Li C, Lai H, Liu X, Zhang L Nutrients. 2021; 13(12).

PMID: 34959871 PMC: 8706888. DOI: 10.3390/nu13124319.

Probiotics for treating acute infectious diarrhoea.

Collinson S, Deans A, Padua-Zamora A, Gregorio G, Li C, Dans L Cochrane Database Syst Rev. 2020; 12:CD003048.

PMID: 33295643 PMC: 8166250. DOI: 10.1002/14651858.CD003048.pub4.

AGA Technical Review on the Role of Probiotics in the Management of Gastrointestinal Disorders.

Preidis G, Weizman A, Kashyap P, Morgan R Gastroenterology. 2020; 159(2):708-738.e4.

PMID: 32531292 PMC: 8018518. DOI: 10.1053/j.gastro.2020.05.060.

References

Guarino A, Dupont C, Gorelov A, Gottrand F, Lee J, Lin Z . The management of acute diarrhea in children in developed and developing areas: from evidence base to clinical practice. Expert Opin Pharmacother. 2011; 13(1):17-26. DOI: 10.1517/14656566.2011.634800. View

Dekate P, Jayashree M, Singhi S . Management of acute diarrhea in emergency room. Indian J Pediatr. 2012; 80(3):235-46. DOI: 10.1007/s12098-012-0909-3. View

Piescik-Lech M, Shamir R, Guarino A, Szajewska H . Review article: the management of acute gastroenteritis in children. Aliment Pharmacol Ther. 2012; 37(3):289-303. DOI: 10.1111/apt.12163. View

Salvatore S, Hauser B, Devreker T, Vieira M, Luini C, Arrigo S . Probiotics and zinc in acute infectious gastroenteritis in children: are they effective?. Nutrition. 2007; 23(6):498-506. DOI: 10.1016/j.nut.2007.03.008. View

Dianawati D, Shah N . Survival, acid and bile tolerance, and surface hydrophobicity of microencapsulated B. animalis ssp. lactis Bb12 during storage at room temperature. J Food Sci. 2012; 76(9):M592-9. DOI: 10.1111/j.1750-3841.2011.02422.x. View

Narayanappa D . Randomized double blinded controlled trial to evaluate the efficacy and safety of Bifilac in patients with acute viral diarrhea. Indian J Pediatr. 2008; 75(7):709-13. DOI: 10.1007/s12098-008-0134-2. View

Dalgic N, Sancar M, Bayraktar B, Pullu M, Hasim O . Probiotic, zinc and lactose-free formula in children with rotavirus diarrhea: are they effective?. Pediatr Int. 2011; 53(5):677-682. DOI: 10.1111/j.1442-200X.2011.03325.x. View

Patro B, Golicki D, Szajewska H . Meta-analysis: zinc supplementation for acute gastroenteritis in children. Aliment Pharmacol Ther. 2009; 28(6):713-23. DOI: 10.1111/j.1365-2036.2008.03787.x. View

Agustina R, Kok F, van de Rest O, Fahmida U, Firmansyah A, Lukito W . Randomized trial of probiotics and calcium on diarrhea and respiratory tract infections in Indonesian children. Pediatrics. 2012; 129(5):e1155-64. DOI: 10.1542/peds.2011-1379. View

10.

Vanhee L, Goeme F, Nelis H, Coenye T . Quality control of fifteen probiotic products containing Saccharomyces boulardii. J Appl Microbiol. 2010; 109(5):1745-52. DOI: 10.1111/j.1365-2672.2010.04805.x. View

11.

Sazawal S, Jalla S, Mazumder S, Sinha A, Black R, Bhan M . Effect of zinc supplementation on cell-mediated immunity and lymphocyte subsets in preschool children. Indian Pediatr. 1997; 34(7):589-97. View

12.

Vandenplas Y, De Hert S . Randomised clinical trial: the synbiotic food supplement Probiotical vs. placebo for acute gastroenteritis in children. Aliment Pharmacol Ther. 2011; 34(8):862-7. DOI: 10.1111/j.1365-2036.2011.04835.x. View

13.

Heaton K, Radvan J, Cripps H, Mountford R, Braddon F, Hughes A . Defecation frequency and timing, and stool form in the general population: a prospective study. Gut. 1992; 33(6):818-24. PMC: 1379343. DOI: 10.1136/gut.33.6.818. View

14.

Allen S, Martinez E, Gregorio G, Dans L . Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev. 2010; (11):CD003048. PMC: 6532699. DOI: 10.1002/14651858.CD003048.pub3. View

15.

Shamir R, Makhoul I, Etzioni A, Shehadeh N . Evaluation of a diet containing probiotics and zinc for the treatment of mild diarrheal illness in children younger than one year of age. J Am Coll Nutr. 2005; 24(5):370-5. DOI: 10.1080/07315724.2005.10719487. View

16.

Rerksuppaphol S, Rerksuppaphol L . Lactobacillus acidophilus and Bifidobacterium bifidum stored at ambient temperature are effective in the treatment of acute diarrhoea. Ann Trop Paediatr. 2010; 30(4):299-304. PMC: 3026296. DOI: 10.1179/146532810X12858955921159. View

17.

Wadhwa N, Chandra Mouli Natchu U, Sommerfelt H, Strand T, Kapoor V, Saini S . ORS containing zinc does not reduce duration or stool volume of acute diarrhea in hospitalized children. J Pediatr Gastroenterol Nutr. 2011; 53(2):161-7. DOI: 10.1097/MPG.0b013e318213ca55. View

18.

Thomas D, Greer F . Probiotics and prebiotics in pediatrics. Pediatrics. 2010; 126(6):1217-31. DOI: 10.1542/peds.2010-2548. View

19.

Hoque K, Binder H . Zinc in the treatment of acute diarrhea: current status and assessment. Gastroenterology. 2006; 130(7):2201-5. DOI: 10.1053/j.gastro.2006.02.062. View

20.

Salazar-Lindo E, Miranda-Langschwager P, Campos-Sanchez M, Chea-Woo E, Sack R . Lactobacillus casei strain GG in the treatment of infants with acute watery diarrhea: a randomized, double-blind, placebo controlled clinical trial [ISRCTN67363048]. BMC Pediatr. 2004; 4:18. PMC: 517719. DOI: 10.1186/1471-2431-4-18. View