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. 2021 Dec;10(12):3248-3260.
doi: 10.21037/tp-21-511.

Efficacy of probiotics in the treatment of acute diarrhea in children: a systematic review and meta-analysis of clinical trials

Rao Huang #  1 , Hong-Yi Xing #  2 , Hong-Juan Liu  1 , Ze-Fu Chen  3 , Bi-Bo Tang  4
Affiliations

Efficacy of probiotics in the treatment of acute diarrhea in children: a systematic review and meta-analysis of clinical trials

Rao Huang et al. Transl Pediatr. 2021 Dec.

Abstract

Background: If acute diarrhea in children is not treated promptly and effectively, it can lead to severe dehydration and serious sequelae. Due to the imbalance of intestinal bacteria in children with acute diarrhea, the supplementation with probiotics is important, which can improve the intestinal microenvironment, promote immunity, and enhance resistance. This meta-analysis provides further evidence and discussion of the therapeutic effect of probiotics on acute diarrhea in children.

Methods: MEDLINE, EMBASE, PubMed, and the Cochrane Library databases were searched by rapid matching. The input keywords were as follows: (probiotics/synbiotics) and (child/children) and (acute diarrhea/acute gastroenteritis). Articles reporting on randomized controlled trials (RCTs) of probiotics in treating acute diarrhea in children were retrieved. The studies were published from 2010 to 2020. After screening and quality evaluation, Stata 16.0 software was used for the analysis.

Results: Twelve articles with 744 patients were included in the study, and the overall quality of the articles was excellent. Meta-analysis showed that the duration of diarrhea in the probiotics group was shorter than that in the control group [standard mean difference (SMD) =-0.74, 95% CI: -1.11 to -0.37, Z=-3.935, P=0.000], the 2-day treatment efficacy for diarrhea in the probiotics group was greater than that in the control group [odds ratio (OR) =2.12, 95% CI: 1.47-3.05, Z=3.998, P=0.000], and the length of hospital stay in the probiotics group was shorter than that of the control group (SMD =-0.60, 95% CI: -0.74 to -0.47, Z=-8.781, P=0.000). In the subgroup analysis, combined probiotics shortened the duration of diarrhea compared with single probiotic use, and Lactobacillus reuteri and Saccharomyces boulardii had a better therapeutic effect than Lactobacillus rhamnosus or Lactobacillus acidophilus.

Discussion: In the treatment of acute diarrhea in children, the addition of probiotics can shorten the duration of diarrhea, increase treatment efficacy after 2 days of treatment, and shorten the length of hospital stay. However, because of possible publication bias in the current study, further high-quality RCT studies in clinical settings are needed to verify the current results and continue the exploration of this topic.

Keywords: Probiotics; acute diarrhea; children; meta-analysis.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/tp-21-511). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Literature screening flow chart. RCT, randomized controlled trial.
Figure 2
Figure 2
Effect of probiotic treatment on duration of diarrhea.
Figure 3
Figure 3
Effect of probiotic treatment on the 2-day treatment efficacy rate for diarrhea.
Figure 4
Figure 4
Effect of probiotic therapy on the length of hospital stay.
Figure 5
Figure 5
Analysis of the effect of probiotics on the duration of diarrhea by location.
Figure 6
Figure 6
Analysis of the effect of probiotics on the duration of diarrhea according to whether probiotics were combined.
Figure 7
Figure 7
Analysis of the effect of probiotics on the duration of diarrhea according to the probiotic species.
Figure 8
Figure 8
Sensitivity analysis.
Figure 9
Figure 9
Funnel plot analysis of efficacy rate.
See this image and copyright information in PMC

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