Probiotic for Children with Gastroenteritis

      • Gastroenteritis accounts for approximately 1.7 million visits to the emergency department (ED) by only children  in the United States  every year (video on Russian)

    • Data to determine whether the use of probiotics improves outcomes in these children are lacking
    • Some professional societies recommend using probiotics to treat acute gastroenteritis but supporting them data still based on underpowered studies with methodological errors in the design related trials
    • A Position Paper by The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Working Group for Probiotics and Prebiotics (J Pediatric Gastroenterol and Nutrition; 2014; V 58; Iss 4: p 531–539)
      • The use of the following probiotics may be considered in the management of children with acute gastroenteritis: Lactobacillus rhamnosus GG (low quality of evidence, strong recommendation) and Saccharomyces boulardii (low quality of evidence, strong recommendation)
      • Less compelling evidence is available for Lactobacillus reuteri DSM 17938 (very low quality of evidence, weak recommendation) and heat-inactivated Lactobacillus acidophilus LB (very low quality of evidence, weak recommendation)
    • Multi-center Trial of a Combination Probiotic for Children with Gastroenteritis” (Engl J Med 2018; 379:2015-2026)
      • Probiotics failed to perform better than placebo at reducing the progression or severity of gastroenteritis
      • In children who presented to the emergency department with gastroenteritis, twice-daily administration of a combined L. rhamnosus–L. helveticus probiotic did not prevent the development of moderate-to-severe gastroenteritis within 14 days after enrollment
    • With their low cost and minimal side effects, probiotics have a potential for the treatment of different diseases, but rigorous trials are required to determine any potential efficacy or effectiveness 
    • In like situations you can whistle for your money!

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