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Meta-Analysis
. 2019 Sep;98(37):e16618.
doi: 10.1097/MD.0000000000016618.

A meta-analysis of the effects of probiotics and synbiotics in children with acute diarrhea

Bo Yang  1   2 , Ping Lu  3 , Mei-Xuan Li  4 , Xiao-Ling Cai  1 , Wan-Yuan Xiong  2 , Huai-Jing Hou  2 , Xiao-Qin Ha  1
Affiliations
Meta-Analysis

A meta-analysis of the effects of probiotics and synbiotics in children with acute diarrhea

Bo Yang et al. Medicine (Baltimore). 2019 Sep.

Abstract

Objective: This meta-analysis assessed the effectiveness of probiotics and synbiotics for acute diarrhea (AD) in children and investigated probiotic formulations, types of interventions, and country factors.

Methods: Randomized, double-blind, placebo-controlled trials evaluating the effects of probiotics or synbiotics on AD were analyzed. We followed the recommendations of the Cochrane Handbook and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. The risks of systematic errors (bias) and random errors were assessed, and the overall quality of the evidence was evaluated using the Grades of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

Results: The meta-analysis included 34 studies with 4911 patients. Five and 29 studies presented the results of synbiotic and probiotic interventions, respectively. After intervention, the durations of diarrhea (weighted mean difference (WMD) = -16.63 [-20.16; -12.51]) and hospitalization (risk ratio (RR) = 0.59 [0.48; 0.73]) were shorter, the stool frequency on day 3 (WMD = -0.98 [-1.55; -0.40]) was decreased, and the incidence of diarrhea lasting 3 days was lower in the probiotic and synbiotic groups than in the control groups. Furthermore, in the subgroup analyses, synbiotics were more effective than probiotics at reducing the durations of diarrhea and hospitalization, and Saccharomyces and Bifidobacterium were more effective than Lactobacillus at reducing the duration of diarrhea.

Conclusion: This meta-analysis supports the potential beneficial roles of probiotics and synbiotics for AD in children. Further research is needed to determine problems associated with probiotic/synbiotic mixtures and appropriate dosages.

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Conflict of interest statement

The authors have no conflicts of interests to disclose.

Figures

Figure 1
Figure 1
Flowchart of the selection of studies on the effects of probiotics and synbiotics in children with AD.
Figure 2
Figure 2
Bias risk assessment of the RCTs on the effects of probiotics and synbiotics in children with AD.
Figure 3
Figure 3
Meta-analysis results for probiotics and synbiotics in AD. Meta-analysis results of (a) the duration of diarrhea in AD, (b) the duration of hospitalization, (c) the duration of stool frequency at 3 days, (d) diarrhea lasting 3 days, (e) the duration of fever, and (f) the duration of vomiting in children with AD.
Figure 3 (Continued)
Figure 3 (Continued)
Meta-analysis results for probiotics and synbiotics in AD. Meta-analysis results of (a) the duration of diarrhea in AD, (b) the duration of hospitalization, (c) the duration of stool frequency at 3 days, (d) diarrhea lasting 3 days, (e) the duration of fever, and (f) the duration of vomiting in children with AD.
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References

    1. Guarino A, Dupont C, Gorelov AV, et al. The management of acute diarrhea in children in developed and developing areas: from evidence base to clinical practice. Expert Opin Pharmacother 2012;13:17–26. - PubMed
    1. Applegate JA, Walker CLF, Ambikapathi R, et al. Systematic review of probiotics for the treatment of community-acquired acute diarrhea in children. BMC Public Health 2013;13Suppl 3:S16. - PMC - PubMed
    1. Wardlaw T, Salama P, Brocklehurst C, et al. Diarrhoea: why children are still dying and what can be done. Lancet 2010;375:870–2. - PubMed
    1. Pawlowski SW, Warren CA, Guerrant R. Diagnosis and treatment of acute or persistent diarrhea. Gastroenterology 2009;136:1874–86. - PMC - PubMed
    1. Gadewar S, Fasano A. Current concepts in the evaluation, diagnosis and management of acute infectious diarrhea. Curr Opin Pharmacol 2005;5:559–65. - PubMed

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