Open AccessSpecific Probiotics for the Treatment of Pediatric Acute Gastroenteritis in India
Author(s) -
McFarland Lynne V.,
Srinivasan Ramesh,
Setty Rajendra P.,
Ganapathy Sridhar,
Bavdekar Ashish,
Mitra Monjori,
Raju Bhaskar,
Mohan Neelam
Publication year - 2021
Publication title -
jpgn reports
Language(s) - English
Resource type - Journals
ISSN - 2691-171X
DOI - 10.1097/pg9.0000000000000079
Subject(s) - saccharomyces boulardii , probiotic , lactobacillus rhamnosus , medicine , randomized controlled trial , diarrhea , meta analysis , acute gastroenteritis , confidence interval , pediatrics , gastroenterology , biology , genetics , bacteria
Pediatric acute gastroenteritis (PAGE) is a significant cause of morbidity, mortality and healthcare costs in many countries, but differences in PAGE vary from country‐to‐country; thus, we limited our analysis to 1 country. Probiotics have been recommended as an adjunct to standard treatment, but the choice of probiotic is unclear. PubMed, Google Scholar, and reviews were searched from inception to May 2020 for randomized controlled trials (RCTs) in India using probiotics for a treatment for PAGE. Meta‐analyses using subgroups of identical probiotic types (≥2 RCT/type) were conducted for primary outcomes (duration of diarrhea, cured by day 3, rapidity of response, and length of hospital stay). Twenty‐two RCTs were included in the systematic review (N = 4059 participants) including 5 single‐strained probiotics and 3 multi‐strained mixtures. For the meta‐analyses, 17 RCT (20 treatment arms) were included. Saccharomyces boulardii CNCM I‐745 had the strongest effect on shortening the duration of diarrhea (standardized mean difference, –1.86 d; 95% confidence interval, –2.8 to –0.9), while both Lactobacillus rhamnosus GG and a mixture of 4 Bacillus clausii strains (O/C, SIN, N/R, T) significantly reduced the duration of diarrhea (–1.7 and –1.4 d, respectively). S. boulardii and L. rhamnosus GG significantly reduced hospital stays (−1.8 and −1.1 d, respectively), while B. clausii had no effect. The frequency of stools/day was significantly reduced by day 4 for S. boulardii and by day 5 for L. rhamnosus GG. In India, 2 types of probiotics ( S. boulardii CNCM I‐745 and L. rhamnosus GG) significantly shortened both the duration of diarrhea and hospitalization stays in pediatric patients with PAGE. While these 2 probiotic strains were safe and effective for children in India, further research is needed to confirm if other probiotic strains or mixtures may be effective.