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Meta‐analysis: L actobacillus GG for treating acute gastroenteritis in children – updated analysis of randomised controlled trials
Author(s) -
Szajewska H.,
Skórka A.,
Ruszczyński M.,
GieruszczakBiałek D.
Publication year - 2013
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.12403
Subject(s) - medicine , meta analysis , randomized controlled trial , cochrane library , acute gastroenteritis , placebo , probiotic , medline , pediatrics , gastroenterology , alternative medicine , pathology , biology , bacteria , political science , law , genetics
Summary Background The efficacy of each probiotic should be evaluated separately. Previously, we have shown that L actobacillus GG (LGG) is effective in treating acute gastroenteritis (AGE) in children. Aim To update our 2007 meta‐analysis on the effectiveness of LGG in treating AGE in children. Methods The Cochrane Library, MEDLINE and EMBASE databases were searched from August 2006 (end date of last search) to May 2013, with no language restrictions, for randomised controlled trials (RCTs) and meta‐analyses. Results Fifteen RCTs (2963 participants) met the inclusion criteria in this updated meta‐analysis. Combined data from 11 RCTs ( n = 2444) showed that LGG significantly reduced the duration of diarrhoea compared with placebo or no treatment (mean difference, MD −1.05 days, 95% CI −1.7 to −0.4). LGG was more effective when used at a daily dose ≥10 10 CFU (eight RCTs, n = 1488, MD −1.11 days, 95% CI −1.91 to −0.31) than when used at a daily dose <10 10 CFU (three RCTs, n = 956, MD −0.9 day, 95% CI −2.5 to 0.69). LGG was effective in children treated in Europe (five RCTs, n = 744, MD −1.27 days, 95% CI −2.04 to −0.49); in the non‐European setting, the difference between the LGG group and the control group was of a borderline statistical significance (six RCTs, n = 1700, MD −0.87, 95% CI −1.81 to 0.08). Conclusions Lactobacillus GG reduces the duration of diarrhoea. A subset of patients that is more likely to benefit includes subjects treated with a high daily dose of LGG (≥10 10 CFU/day) who are either in‐patients or out‐patients from geographical Europe. Given the methodological limitations of many of the included trials, the evidence should be viewed with caution.