Abstract
The effectiveness of Lactobacillus reuteri DSM 17938 (L. reuteri) for the management of acute gastroenteritis (AGE) has been recently questioned. We performed a systematic review to update evidence on L. reuteri for treating AGE in children. We searched MEDLINE, EMBASE, the Cochrane Library databases, and additional data sources from January 2016 (end of search for our 2016 systematic review) to August 2019. The primary outcomes were stool volume and duration of diarrhea. Four RCTs were included. None of them evaluated stool volume. Compared with placebo or no treatment, L. reuteri reduced diarrhea duration (four RCTs, n = 347, mean difference, MD −0.87 days, 95% CI [−1.43, −0.31]). L. reuteri use was also associated with a reduced duration of hospitalization (three RCTs, n = 284, MD −0.54 days, 95% CI [−1.09, 0.0]). The small effect sizes of limited clinical relevance and methodological limitations of the included trials should be noted when interpreting these findings.
Highlights
Acute gastroenteritis (AGE) in children remains a common health problem
The daily doses of L. reuteri DSM 17938 ranged from 1 × 108 CFU (5 days) to 2 × 108 CFU (5 days) to 4 × 108 CFU (7 days)
L. reuteri DSM 17938 was used in addition to rehydration therapy consisting of an oral rehydration solution and/or intravenous rehydration
Summary
Acute gastroenteritis (AGE) in children remains a common health problem. Despite treatment advances in recent decades, globally, diarrhea is one of the leading causes of death in the pediatric population, especially in children younger than the age of 5 years [1]. Childhood AGE accounts for significant healthcare system costs, mainly associated with hospital admissions and physician consultations [2]. Rotavirus vaccination has been introduced recently in many countries, this form of primary prevention has not overthrown the burden of AGE [1]. A focus on effective diarrhea management is still timely and of importance. Probiotics have been extensively studied as a supportive treatment regimen in children with
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