 |
|
 |
|
 |
 |
|
 |
 |
 |
 |
 |
 |
 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
REVIEW ARTICLE |
,
,
* Sea Mar Community Health Center, Seattle, Washington
Department of Pediatrics, University of Washington, Seattle, Washington
Child Health Institute, University of Washington, Seattle, Washington
--> Objective. Childhood diarrhea accounts for substantial morbidity and mortality worldwide. Multiple studies in children have shown that Lactobacillus, administered orally, may have antidiarrheal properties. We conducted a meta-analysis of randomized, controlled studies to assess whether treatment with Lactobacillus improves clinical outcomes in children with acute infectious diarrhea.
Methods. Studies were sought in bibliographic databases of traditional biomedical as well as complementary and alternative medicine literature published from 1966 to 2000. Search terms were "competitive inhibition," "diarrhea," "gastroenteritis," "Lactobacillus," "probiotic," "rotavirus," and "yog(h)urt." We included studies that were adequately randomized, blinded, controlled trials in which the treatment group received Lactobacillus and the control group received an adequate placebo and that reported clinical outcome measures of diarrhea intensity. These inclusion criteria were applied by blind review and consensus. The original search yielded 26 studies, 9 of which met the criteria. Multiple observers independently extracted study characteristics and clinical outcomes. Data sufficient to perform meta-analysis of the effect of Lactobacillus on diarrhea duration and diarrhea frequency on day 2 were contained in 7 and 3 of the included studies, respectively.
Results. Summary point estimates indicate a reduction in diarrhea duration of 0.7 days (95% confidence interval: 0.3–1.2 days) and a reduction in diarrhea frequency of 1.6 stools on day 2 of treatment (95% confidence interval: 0.7–2.6 fewer stools) in the participants who received Lactobacillus compared with those who received placebo. Details of treatment protocols varied among the studies. A preplanned subanalysis suggests a dose-effect relationship.
Conclusion. The results of this meta-analysis suggest that Lactobacillus is safe and effective as a treatment for children with acute infectious diarrhea.
Key Words: gastroenteritis • infectious diarrhea • Lactobacillus • meta-analysis • rotavirus
Abbreviations: ID, acute infectious diarrhea • ORS, oral rehydration solution • CI, confidence interval
This article has been cited by other articles:
 |
|
 |
|
  E. Denou, R. D. Pridmore, B. Berger, J.-M. Panoff, F. Arigoni, and H. Brussow Identification of Genes Associated with the Long-Gut-Persistence Phenotype of the Probiotic Lactobacillus johnsonii Strain NCC533 Using a Combination of Genomics and Transcriptome Analysis J. Bacteriol., May 1, 2008; 190(9): 3161 - 3168. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. R. Smith and D. T. Blumstein Fitness consequences of personality: a meta-analysis Behav. Ecol., March 1, 2008; 19(2): 448 - 455. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Lievin-Le Moal, L. E. Sarrazin-Davila, and A. L. Servin An Experimental Study and a Randomized, Double-Blind, Placebo-Controlled Clinical Trial to Evaluate the Antisecretory Activity of Lactobacillus acidophilus Strain LB Against Nonrotavirus Diarrhea Pediatrics, October 1, 2007; 120(4): e795 - e803. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. B. Canani, P. Cirillo, G. Terrin, L. Cesarano, M. I. Spagnuolo, A. D. Vincenzo, F. Albano, A. Passariello, G. D. Marco, F. Manguso, et al. Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations BMJ, August 18, 2007; 335(7615): 340 - 340. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Bass, D. A. Pappano, and S. G. Humiston Rotavirus Pediatr. Rev., May 1, 2007; 28(5): 183 - 191. [Full Text] [PDF]
|
|
|
|
 |
|
 M. de Vrese and P. R. Marteau Probiotics and Prebiotics: Effects on Diarrhea J. Nutr., March 1, 2007; 137(3): 803S - 811S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Zareie, K Johnson-Henry, J Jury, P-C Yang, B-Y Ngan, D M McKay, J D Soderholm, M H Perdue, and P M Sherman Probiotics prevent bacterial translocation and improve intestinal barrier function in rats following chronic psychological stress Gut, November 1, 2006; 55(11): 1553 - 1560. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. K. Orr, K. L. Matson, and B. J. Cowles Nonprescription Medication Use by Infants and Children: Product Labeling Versus Evidence-Based Medicine Journal of Pharmacy Practice, October 1, 2006; 19(5): 286 - 294. [Abstract] [PDF]
|
|
|
|
 |
|
 C. C. Roy, C. L. Kien, L. Bouthillier, and E. Levy Short-Chain Fatty Acids: Ready for Prime Time? Nutr Clin Pract, August 1, 2006; 21(4): 351 - 366. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. D. Cabana, A. L. Shane, C. Chao, and M. Oliva-Hemker Probiotics in primary care pediatrics. Clinical Pediatrics, June 1, 2006; 45(5): 405 - 410. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Shamir, I. R. Makhoul, A. Etzioni, and N. Shehadeh 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., October 1, 2005; 24(5): 370 - 375. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Weizman, G. Asli, and A. Alsheikh Effect of a Probiotic Infant Formula on Infections in Child Care Centers: Comparison of Two Probiotic Agents Pediatrics, January 1, 2005; 115(1): 5 - 9. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. W. Van Niel Probiotics: Not Just for Treatment Anymore Pediatrics, January 1, 2005; 115(1): 174 - 177. [Full Text] [PDF]
|
|
|
|
|
|
M. H. Land, K. Rouster-Stevens, C. R. Woods, M. L. Cannon, J. Cnota, and A. K. Shetty Lactobacillus Sepsis Associated With Probiotic Therapy Pediatrics, January 1, 2005; 115(1): 178 - 181. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H S Gill and F Guarner Probiotics and human health: a clinical perspective Postgrad. Med. J., September 1, 2004; 80(947): 516 - 526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Adolfsson, S. N. Meydani, and R. M Russell Yogurt and gut function Am. J. Clinical Nutrition, August 1, 2004; 80(2): 245 - 256. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Ott, M. Musfeldt, U. Ullmann, J. Hampe, and S. Schreiber Quantification of Intestinal Bacterial Populations by Real-Time PCR with a Universal Primer Set and Minor Groove Binder Probes: a Global Approach to the Enteric Flora J. Clin. Microbiol., June 1, 2004; 42(6): 2566 - 2572. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Focht III Impact of Bifidobacterium on Infantile Diarrhea AAP Grand Rounds, June 1, 2004; 11(6): 65 - 66. [Full Text] [PDF]
|
|
|
|
|
|
J. Schrezenmeir, K. Heller, M. McCue, C. Llamas, W. Lam, H. Burow, M. Kindling-Rohracker, W. Fischer, H. C. Sengespeik, G. M. Comer, et al. Benefits of Oral Supplementation With and Without Synbiotics in Young Children With Acute Bacterial Infections Clinical Pediatrics, April 1, 2004; 43(3): 239 - 249. [Abstract] [PDF]
|
|
|
|
 |
|
 M Millar, M Wilks, and K Costeloe Probiotics for preterm infants? Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2003; 88(5): F354 - F358. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S V. Karthik Probiotics in inflammatory bowel disease J R Soc Med, July 1, 2003; 96(7): 370 - 370. [Full Text] [PDF]
|
|
|
|
|
|
Minerva BMJ, February 1, 2003; 326(7383): 292 - 292. [Full Text] [PDF]
|
|
|
|
 |
|
 OTHER ARTICLES NOTED (Nov 01 to 18 Oct 02) Evid. Based Nurs., January 1, 2003; 6(1): e1 - 1. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Uhari Review: Lactobacillus is safe and effective for treating children with acute infectious diarrhoea Evid. Based Med., November 1, 2002; 7(6): 185 - 185. [Full Text] [PDF]
|
|
|
|
|
|
M. Dubik and L. L. Barton Efficacy of Lactobacillus Therapy for Acute Diarrhea AAP Grand Rounds, June 1, 2002; 7(6): 62 - 63. [Full Text] [PDF]
|
|
|
|
 |
|
 Does Lactobacillus Ease Acute Diarrhea in Children? Journal Watch Infectious Diseases, April 25, 2002; 2002(425): 4 - 4. [Full Text]
|
|
Read all P3Rs
 |
||
|
||
Home | My Pediatrics | Journal Information | Current Issue | Past Issues | Subscriptions & Services | Contact Us Click here for faster international access © 2002 American Academy of Pediatrics. All rights reserved. |
||
|
||
