Duration Of Diarrhea In Children Research Articles

Zinc Deficiency and Therapeutic Value of Zinc Supplementation in Pediatric Gastrointestinal Diseases.

The benefits of zinc in treating certain gastrointestinal (GI) diseases have been recognized for over two decades. This review aims to explore zinc deficiency (ZD) and the potential therapeutic value and safety of zinc supplementation in pediatric GI diseases. A systematic review of published articles on ZD and zinc as adjuvant treatments for GI diseases was conducted using various databases. Children with inflammatory bowel disease (IBD), celiac disease, and those receiving long-term proton pump inhibitor treatments are particularly susceptible to ZD. ZD in children with celiac disease and IBD is attributed to insufficient intake, reduced absorption, and increased intestinal loss as a result of the inflammatory process. Zinc plays a crucial role in maintaining the integrity of the gastric mucosa and exerts a gastroprotective action against gastric lesions. Although considerable evidence supports the use of zinc as adjuvant therapy for certain GI diseases in adults, its use is unspecified in children except for infectious diarrhea. Current evidence suggests that zinc supplementation with well-documented dosages helps reduce the duration of diarrhea in children with acute or persistent diarrhea, while there are no specific guidelines for zinc supplementation in children with IBD and celiac disease. Zinc supplementation appears to be beneficial in peptic ulcer disease or gastroesophageal reflux disease. The available evidence highlights the need for intervention programs to enhance zinc status and reduce the morbidity of certain GI diseases in children.

Pengaruh Suplementasi Saccharomyces boulardii terhadap Kejadian Diare pada Balita

Diarrhea is a disease that occurs due to viral or bacterial infection in the digestive tract system. Signs of diarrhea are the stool becomes liquid and the frequency of bowel movements is more than three times a day and is accompanied by blood and mucus or only mucus. Saccharomyces boulardii is a probiotic yeast with proven medicinal benefits, especially in the gastrointestinal tract and antibiotic booster. Objectives: To describe the effect of Saccharomyces boulardii supplementation on the incidence of diarrhea in toddlers. Methods: Literature review method with 11 articles (2011-2021) and the keywords used are "Saccharomyces boulardii, diarrhea, toddler". Journal search with Google scholar, Scopus and Pubmed. Reputable journals SINTA S1 with 1, Scopus Q1 with 3 articles, Q2 with 2 articles, Q4 with 5 articles. Results: The results of the literature review showed that as many as ten articles (90.9%) stated that Saccharomyces boulardii supplementation had a significant effect on reducing the duration of diarrhea in children under five. In addition to the effect on the duration of diarrhea in toddlers, there are also 5 articles (45.4%) stating that there is an effect on reducing the frequency of diarrhea in toddlers on the second day after supplementation with Saccharomyces boulardii. Conclusion: There is an effect of Saccharomyces boulardii supplementation on reducing the duration and frequency of diarrhea in toddlers.Keywords: diarrhea, toddler, Saccharomyces boulardii

Saccharomyces boulardii plus azithromycin is superior to azithromycin alone in reducing the duration of diarrhea in children with acute colitis: a double-blind randomized placebo-controlled trial

Introduction: Diarrheal disorders remain a major disease burden throughout the world in pediatrics that remains a health problem. Several treatment methods have been proposed to treat diarrhea, however each of them has some problems. Objectives: The aim of this study was the evaluation the effect of oral Saccharomyces boulardii on the duration and severity of colitis. Patients and Methods: This randomized clinical trial study included ninety-four patients with acute colitis were enrolled. The children were divided randomly into case and control groups. The control group received supportive treatment including intravenous or oral fluid therapy (ORS solution), antibiotic treatment with azithromycin suspension, and zinc sulfate syrup daily for five days. In addition to the mentioned treatments, the intervention group received S. boulardii as a probiotic capsule. Then, the duration and severity of diarrhea based on the Vesikari score were evaluated for all the patients for five first days. Results: The mean of Vesikari score after the first day in both groups was similar, while after the third and fifth day in the probiotic group this score was lower than the control group (5.11 ± 1.73 versus 6.13 ± 2.25, P=0.031 and 2.36 ± 1.16 versus 4.28 ±1.19, P<0.001, respectively). Furthermore, the number of diarrhea per day in the probiotic group was significantly lower after the first day in contrast to the control group, which remains significant at the end of the fifth day (2.32 ± 0.51 versus 2.83 ± 1.23, P=0.047). Moreover, we found that the diarrhea duration (P<0.001), fever duration (P=0.029), and duration of hospitalization (P=0.006) were statistically lower in the case group as compared to the control. Conclusion: Saccharomyces boulardii had a beneficial effect as a probiotic agent in reducing the severity and duration of diarrhea, which could be beneficial for the treatment of colitis. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20161026030525N2); https://www.irct.ir/trial/24229; ethical code: IR.AJUMS.REC.1395.54.

Comparison of mean duration of diarrhea of two different probiotics in Acute Diarrhea among children - RCT

Background: Diarrhea is one of the leading causes of morbidity and mortality and morbidity in paediatric age group. Aim: To determine compare the mean duration of diarrhea in single strain (saccharomyces boulardii) and multiple strain probiotic in acute diarrhea in children. Study Design: Randomized controlled trial. Methodology: The current project was conducted at Department of Pediatrics, General Hospital, Lahore. The patients were randomly categorized in two groups. 5 billion lyophilized heat-killed multiple strain probiotic (Group-B) was given twice a day and 250 mg of saccharomyces boulardii (Group-A) was given twice a day. Data analyzed by using SPSS 15.0. Independent t-test was applied for comparison of mean duration of diarrhea between groups. Results: The mean age of patients were 14.3 ± 4.19 months. The mean duration of diarrhea in Group A was 78.7±13.2 hrs whereas in Group B, mean duration of diarrhea was 97.6 ± 13.6 hrs. Conclusion: Single strain saccharomyces boulardii significantly reduced the mean duration of diarrhea in children. Keywords: Probiotics, Saccharomyces Boulardii, Acute Diarrhea and Children.

Діарея у дітей молодшого віку (клініка, діагностика, принципи терапії)

Багато захворювань у дітей раннього та молодшого віку супроводжує розвиток діарейного синдрому. У результаті в кишечнику виникають органічні ураження і функціональні порушення. Від гострої діареї в світі щорічно страждають до 1,4 більйона дітей молодше 5 років, із них 123 млн змушені екстрено звертатися за медичною допомогою, 9 млн потребують стаціонарного лікування, а 1,8 млн дітей помирають від дегідратації. У зв’язку з цим є актуальним питання про вибір терапевтичної тактики. Засоби, що уповільнюють моторику кишечника (лоперамід), протипоказані при гострих діареях у дітей, оскільки є високим ризик побічних ефектів, що включають ілеус, сонливість, нудоту (летальність до 1 %). Пробіотики є живими мікробними лікарськими засобами, що зазвичай використовуються для запобігання гострої діареї. Проведено великі дослідження, опубліковані результати метааналізу, що виявили ефект Escherichia coli штам Nissle 1917 (Мутафлор) щодо скорочення тривалості діареї у дітей із гострими гастроентеритами. Escherichia coli штам Nissle 1917 — одна з 3 бактерій у світі, що найкраще охарактеризовані на молекулярно-біологічному рівні, це найбільш вивчений непатогенний і генетично стабільний штам у світі зі 100-річною історією. Він має генетичну карту, його геном є повністю секвенованим, генетичні локуси детерміновані, препарат внесений у Німецький збірник штамів мікроорганізмів і клітинних культур (DSMZ). Метою нашого дослідження було удосконалення терапевтичних підходів до корекції діарейного синдрому з використанням в основних схемах лікування Escherichia coli штам Nissle 1917 (Мутафлор). Було обстежено 74 дитини, які були розділені на дві групи: перша група — діти з діарейним синдромом, яким з першого дня в схему терапії був доданий Мутафлор, друга група — діти з діарейним синдромом, що отримували традиційну терапію. У результаті дослідження були отримані дані, що доводять ефективність застосування Escherichia coli штам Nissle 1917 (Мутафлор) при терапії діареї у дітей молодшого віку, його сприятливий вплив на мікрофлору і нормалізацію кінетики кишечника, швидкість поліпшення клінічної симптоматики. Вищевказане дозволяє рекомендувати пробіотик Mutaflor Suspension® дітям з перших місяців життя.

NITAZOXANIDE IN TREATMENT OF ROTAVIRUS DIARRHEA IN CHILDREN: A SINGLE CENTER STUDY

BACKGROUND & OBJECTIVE: As Rota virus leads to significant morbidity in children 2 months to 5 years, this study was done to observe the effect of one dose of nitazoxanide on the total duration of rotavirus diarrhea. The primary objective was to evaluate the reduction in the mean duration of viral diarrhea in children after administration of first dose of Nitazoxanide.
 METHODLOGY: This descriptive study was done in the Department of Pediatric Medicine Unit I, Mayo Hospital, Lahore from Jan 2016 to June 2016 after approval from the ethical review committee. Sample size calculated was 175 using WHO sample size calculator. Patients of 4–5 years were given 200 mg nitazoxanide twice daily for 3 days; 100 mg nitazoxanide was given twice daily to 12–47 months age group, and patient of <12 months age were given 7.5 mg/kg twice day along with routine care and were followed 12 hourly till the passage of normally formed stools. Duration of diarrhea was recorded.
 RESULTS: Out of 175 cases, 58.9% (n=103) were between 2-36 months age while 41.2% (n=72) were 37-60 months age, mean+SD was calculated as 35.06+13.34 months, mean reduction in duration of rotavirus diarrhea in children after administration of first dose of Nitazoxanide was recorded as 32.85+2.32 hours.
 CONCLUSION: With the use of nitazoxanide along with routine care for rotavirus diarrhea children, the mean duration of rotavirus diarrhea was reported to be less than 1.5 days.

Systematic review with meta-analysis: Probiotics for treating acute diarrhoea in children with dehydration.

This study aimed to evaluate the effectiveness of probiotics in treating children with acute diarrhoea and dehydration. Medline, EMBASE, and the Cochrane Library databases were searched for relevant studies and statistical analysis was performed. A total of 17 randomised controlled trials (RCTs) involving 2861 participants met the inclusion criteria. Compared with placebo, probiotics reduced the duration of diarrhoea (12 RCTs [15, 17], n = 1907, mean difference - 21.33 h, confidence interval (CI) -29.74 to -12.91, high heterogeneity, I2 = 86%), the duration of hospitalisation when compared with placebo (eight RCTs [19, 20], n = 1606, mean difference - 0.83 days, CI -1.53 to -0.12, high heterogeneity, I2 = 96%) and reduced risk of diarrhoea on day 4 or more days (six RCTs [19, 20], n = 1093, risk difference - 0.13, 95% CI -0.17- -0.09, no heterogeneity). Probiotics alongside rehydration therapy appear to be safe and have clear beneficial effects in shortening the duration of diarrhoea in children with acute diarrhoea and dehydration.

The Relationship Between the Incidence of Stunting and the Frequency and Duration of Diarrhea in Toddler in the Working Area of Kenjeran Health Center in Surabaya

Infectious diseases (diarrhea) that repeatedly cause children’s health to increase in the pattern of children’s appetite which can lead to less nutritional status of children. This study was to analyze the relationship between the incidence of stunting and the frequency and duration of diarrhea in children under five in the Kenjeran Health Center Surabaya Working Area. Analytical research design with cross sectional design in 4 villages in Kenjeran Health Center. Data retrieval is done by questionnaire sheet and observation using microtoise, sample technique uses Sampling Probability by using Stratified Random Sampling as many as 152 children. Data were analyzed using the Spearmen Rho statistical test. The results of research on children under five who experience the incidence of stunting with the frequency and duration of diarrheal disease indicate children who experience stunting and longer frequency. The Rho Spearmen Test showed differences in the incidence of stunting with the frequency of diarrhea p = 0.005 (p<α = 0.05), duration of diarrhea p = 0.003 (p<α = 0.05). The implication of this study is that stunting is related to the frequency and duration of diarrheal diseases, so that posyandu activities can add counseling about children’s health that requires the treatment of diarrhea in children under five in the Kenjeran Health Center Surabaya

Effect of Green Banana (Musa paradisiaca) on Recovery in Children With Acute Watery Diarrhea With No Dehydration: A Randomized Controlled Trial

Cooked green banana (Musa paradisiaca) has been observed to be useful in reducing the duration of diarrheal illness in children. To evaluate whether supplementation of cooked green banana shortens the duration of diarrhea in children with acute watery diarrhea with no dehydration. Open label randomized controlled trial. Consecutive children aged 9 months to 5 years who presented with acute watery diarrhea within 48 hours of onset of illness with no dehydration. Children in the control group received standard care, while those in the intervention group received cooked green banana in addition to standard care under supervision in the hospital for 72 hours, and then continued at home until diarrhea stopped or 14th day of illness, whichever is earlier. Proportion of children who improved at 72 hours of intervention (passing formed stools with normal frequency) was considered as the primary outcome and the incidence of complications such as dehydration, persistent diarrhea and secondary lactose intolerance were evaluated as the secondary outcomes. The proportion of children who recovered within 72 hours was significantly higher (62.4%) in the green banana group compared to the control group (47.2%) [RR 1.3 (95% CI 1.05-1.7), NNT=7].The number of children with complications such as dehydration and persistent diarrhea was also signi-ficantly less in the intervention group. Supplementation of cooked green banana in the diet of children with acute watery diarrhea with no dehydration hastens their recovery.

Evaluating efficacy of oral zinc as adjuvant therapy in acute diarrhea in children.

Objectives: To evaluate the efficacy of oral zinc as adjuvant therapy in acute diarrhea comparing frequency and volume of stool and duration of diarrhea in children. Study Design: Case Control study. Setting: Department of Paediatrics, Shaheed Muhtrama Benazir Bhutto Medical College Layari General Hospital, Karachi. Period: September 2017 to August 2018. Material & Methods: A sample of 200 children, age 5- 15 years, suffering from acute diarrhea was divided into control and cases (study group). Oral zinc therapy (20 mg once daily) was given 14 days and its efficacy was observed in terms of stool frequency, stool volume and duration of diarrhea. Variables were noted at 24 hours and 48 hours and on 7th day of hospitalization. Data was analyzed on SPSS statistical software (version 22.0) at 95% confidence interval (P≤ 0.05). Results: Mean ± SD age in control and study group was noted as 9.1± 5.43 years and 9.5±6.02 years respectively (P=0.053). 89% of children of study group were discharged on 3rd day of hospitalization compared to only 45% from control group. Zinc treated study group shows significant decrease in frequency of loose stools, stool volume and lesser duration of hospital stay. Conclusion: Oral zinc therapy was effective in decreasing the frequency of loose stools and volume and lesser duration of hospital stay in children.

Effects of zinc or synbiotic on the duration of diarrhea in children with acute infectious diarrhea.

Probiotic effects on acute infectious diarrhea are strain(s) specific, and all formulations should be evaluated by clinical trials. We aimed to evaluate the effect of a synbiotic preparation on the duration of diarrhea in children compared to a zinc suspension. We conducted a single-center, randomized, and controlled clinical trial in children with acute infectious diarrhea. The first group received a synbiotic preparation containing Lactobacillus casei, L. plantarum, L. rhamnosus, Bifidobacterium lactis and prebiotics; the second group received a zinc suspension (15 mg/day) for 5 days in addition to oral rehydration solution (ORS) and/or intravenous therapy. The third group received ORS and/or intravenous therapy (control group). The primary endpoint was the duration of diarrhea (in hours). The secondary endpoint was the percentage of children with diarrhea during each day of intervention. The duration of diarrhea was significantly reduced in the synbiotic and the zinc groups compared to the control group (91.0±28.9 hours vs. 114.3±30.9 hours, p<0.001; 86.4±30.8 hours vs. 114.3±30.9 hours, p<0.001, respectively). There was no significant difference in the duration of diarrhea between the synbiotic and zinc groups (p>0.05). At 72nd and 96th hours, the percentage of children with diarrhea was lower in the zinc group than in the synbiotic group (p<0.05 for both). Our study showed that zinc or synbiotic supplementation reduced the duration of diarrhea, with better clinical outcomes at 72nd and 96th hours, and both can be used in children with acute diarrhea. To the best of our knowledge, this was the first study to make a comparison between zinc and synbiotics.

Does probiotic therapy reduce the duration of acute diarrhea in children?

Does probiotic therapy reduce the duration of acute diarrhea in children?

Meta-Analysis: Effect of Probiotics on the Frequency and Duration of Diarrhea in Children Under Five

Meta-Analysis: Effect of Probiotics on the Frequency and Duration of Diarrhea in Children Under Five

The role of zinc supplementation for diarrhoea in children: a critical review

Background: Nearly 1.7 million children suffer from diarrhoea and around 760,000 die each year. The high prevalence of diarrhoea in the developing countries is closely related to lack of safe drinking water, inadequate sanitation and hygiene, and poor health and nutritional status. These environmental conditions facilitate the spread of infectious disease easily. The great morbidity and mortality of this preventable and treatable disease raise concern on how to save children from this fatal disease by improving management of diarrhoea. Several studies suggest that zinc deficiency contribute towards high morbidity and mortality in diarrhoea. Further, there is an area of uncertainty regarding how significant zinc supplementation will help to reduce the duration and severity of diarrhoea in children compared to the diarrhoea management without zinc?&#x0D; Objective: To critically analyse the current evidences of zinc supplementation in diarrhoea.&#x0D; Data Sources: Keywords searching through MEDLINE Ovid database and additional references from retrieved articles. Study Selection: Limited to randomized controlled trial(RCT) study design and systematic review studies which were conducted from 2006 to 2016. However, there is one prospective cohort study included as it is a follow-up of subjects who participated in the previous double-blind randomized placebo-controlled trial.&#x0D; Data Synthesis: This review involves a summary of 10 articles that have been appraised on their relevance in evaluating the role of zinc in reducing severity and duration of diarrhoea in children. Further, the literature found is synthesised through method used in the studies and the effectiveness of zinc therapy&#x0D; Conclusion: Zinc is relatively safe to be used and it can improve diarrhoea management especially in developing countries.&#x0D; Bangladesh Journal of Medical Science Vol.18(2) 2019 p.190-195

Meta-Analysis on the Effect of Zinc on Reducing Diarrhea Episode in Toddlers

Background: Diarrhea is a major cause of mortality and morbidity in toddlers in the world. A number of studies have shown that zinc supplements can reduce the severity and duration of diarrhea in toddlers. This study aimed to examine the effectiveness of zinc on reducing diarrhea episode in toddlers. Sub j ects an d Met h od: This was a meta-analysis conducted using PRISMA systematic guideline. Articles published between year 2000 and 2019 were selected from PubMed, Science Direct, and Springer Link databases. Six articles met the Randomized Controlled Trial (RCT) criteria. These studies were conducted in developing countries. A sample of 692 children divided into two groups of 348 zinc and 344 placebo. The data were analyzed by Review Manager (RevMan) 5.3 program. The results were assessed for Mean difference (MD) and the analysis was carried out for heterogeneity. Results: There was a high heterogeneity between experiments (I2 = 91%; p <0.001) so that Random Effects Model (REM) was used. Zinc administration reduced the duration of diarrhea 0.89 days faster than placebo, and it was statistically significant (MD= -0.89; 95% CI= -1.52 to -0.26; p= 0.006). Conclusion : Zinc supplementation is more effective than placebo in reducing the duration of diarrhea in children. Keywords : effectiveness, zinc, diarrhea, toddlers, meta analysis Cor r espondence : Purwika Widayati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: purwika15@gmail.com. Mobile: 081231153131. Indonesian Journal of Medicine (2019), 4(2): 183-191 https://doi.org/10.26911/theijmed.2019.04.02.12

The Efficacy of Zinc Supplementation to Reduce the Duration of Acute Diarrhea in Children

The Efficacy of Zinc Supplementation to Reduce the Duration of Acute Diarrhea in Children

Effectiveness of GASTROFIX on Duration of Diarrhea and Length of Hospitalization in Children with Acute Gastroenteritis: A Randomized Controlled Trial

Background: According to evidence, the main treatment plans for children with gastroenteritis include the use of an oral solution or intravenous infusion for hydration, continued nutrition; zinc supplementation. The aim of this study was to investigate the effectiveness of Gastro-Fix (registered nutritional supplement) versus placebo on length of hospitalization and duration of diarrhea in children with acute gastroenteritis. Materials and Methods: We conducted a double blind randomized placebo-controlled trial in children with acute gastroenteritis (age between 6 and 120 months). Three hundred eligible patients randomly allocated to one of two parallel groups, Intervention received Gastro-Fix, whereas the placebo group received baby food (cereal based on skimmed milk and wheat without mineral) for a total of 6 days. Gastro-Fix and baby food was administered as a same sachet that could be opened and mixed in water. The primary outcome was length of hospitalization and duration of diarrhea. Results: The Mean length of hospitalization in Gastro-Fix and placebo was 3.43+ 0.57 and 4.70+0.59 day respectively (P<0.001). Median duration of diarrhea was 3 days (range: 3-5, IQR: 3–4 days) in the Gastro-Fix group and 5 days (range 3-6, interquartile range [IQR]: 4–5 days) in the placebo group which was statistically significant (P<0.001). The highest efficacy (diarrhea-free percentage of children) of the Gastro-Fix was observed at day 4 (relative risk [RR]: 0.28; 95% confidence interval [CI]: 0.23-0.35), and at day 5 (RR 0.08; 95% CI: 0.03-0.17) after the intervention. Conclusion: Finding of this study showed that Gastro-Fix can be effective in reducing duration of diarrhea and length of hospitalization in children with diarrhea. This product is suggested to be used in children with acute gastroenteritis.

Smectite for acute infectious diarrhoea in children

BackgroundAs mortality secondary to acute infectious diarrhoea has decreased worldwide, the focus shifts to adjuvant therapies to lessen the burden of disease. Smectite, a medicinal clay, could offer a complementary intervention to reduce the duration of diarrhoea.ObjectivesTo assess the effects of smectite for treating acute infectious diarrhoea in children.Search methodsWe searched the Cochrane Infectious Diseases Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Pubmed), Embase (Ovid), LILACS, reference lists from studies and previous reviews, and conference abstracts, up to 27 June 2017.Selection criteriaRandomized and quasi‐randomized trials comparing smectite to a control group in children aged one month to 18 years old with acute infectious diarrhoea.Data collection and analysisTwo review authors independently screened abstracts and the full texts for inclusion, extracted data, and assessed risk of bias. Our primary outcomes were duration of diarrhoea and clinical resolution at day 3. We summarized continuous outcomes using mean differences (MD) and dichotomous outcomes using risk ratios (RR), with 95% confidence intervals (CI). Where appropriate, we pooled data in meta‐analyses and assessed heterogeneity. We explored publication bias using a funnel plot.Main resultsEighteen trials with 2616 children met our inclusion criteria. Studies were conducted in both ambulatory and in‐hospital settings, and in both high‐income and low‐ or middle‐income countries. Most studies included children with rotavirus infections, and half included breastfed children.Smectite may reduce the duration of diarrhoea by approximately a day (MD ‐24.38 hours, 95% CI ‐30.91 to ‐17.85; 14 studies; 2209 children; low‐certainty evidence); may increase clinical resolution at day 3 (risk ratio (RR) 2.10, 95% CI 1.30 to 3.39; 5 trials; 312 children; low‐certainty evidence); and may reduce stool output (MD ‐11.37, 95% CI ‐21.94 to ‐0.79; 3 studies; 634 children; low‐certainty evidence).We are uncertain whether smectite reduces stool frequency, measured as depositions per day (MD ‐1.33, 95% CI ‐2.28 to ‐0.38; 3 studies; 954 children; very low‐certainty evidence). There was no evidence of an effect on need for hospitalization (RR 0.93, 95% CI 0.75 to 1.15; 2 studies; 885 children; low‐certainty evidence) and need for intravenous rehydration (RR 0.77, 95% CI 0.54 to 1.11; 1 study; 81 children; moderate‐certainty evidence). The most frequently reported side effect was constipation, which did not differ between groups (RR 4.71, 95% CI 0.56 to 39.19; 2 studies; 128 children; low‐certainty evidence). No deaths or serious adverse effects were reported.Authors' conclusionsBased on low‐certainty evidence, smectite used as an adjuvant to rehydration therapy may reduce the duration of diarrhoea in children with acute infectious diarrhoea by a day; may increase cure rate by day 3; and may reduce stool output, but has no effect on hospitalization rates or need for intravenous therapy.

The therapeutic efficacy of azithromycin and nitazoxanide in the acute pig model of Cryptosporidium hominis.

Recent reports highlighting the global significance of cryptosporidiosis among children, have renewed efforts to develop control measures. We have optimized the gnotobiotic piglet model of acute diarrhea to evaluate azithromycin (AZR), nitazoxanide (NTZ), or treatment with both against Cryptosporidium hominis, the species responsible for most human cases. Piglets, animals reproducibly clinically susceptible to C. hominis, when inoculated with 106 oocysts, developed acute diarrhea with oocyst excretion in feces within 3 days. Ten day-treatment with recommended doses for children, commencing at onset of diarrhea, showed that treatment with AZR or NTZ relieved symptoms early in the treatment compared with untreated animals. Piglets treated with AZR exhibited no reduction of oocyst excretion whereas treatment with NTZ significantly reduced oocyst shedding early, increasing however after 5 days. While treatment with AZR+NTZ led to considerable symptomatic improvement, it had a modest effect on reducing mucosal injury, and did not completely eliminate oocyst excretion. Doubling the dose of AZR and/or NTZ did not improve the clinical outcome, confirming clinical observations that NTZ is only partially effective in reducing duration of diarrhea in children. This investigation confirms the gnotobiotic piglet as a useful tool for drug evaluation for the treatment of cryptosporidiosis in children.

The Efficacy of Probiotic in Adults with Acute Infectious Diarrhea

Diarrhea is a global health problem with high morbidity and mortality. In developing countries, acute diarrhea is most commonly caused by infectious pathogens. Regardless of the cause, diarrhea is primarily treated by fluid replacement therapy to decrease the risk of dehydration and death, although it does not affect the duration of diarrhea. Probiotics are able to shorten the duration of diarrhea in children, but its efficacy in adults is unclear. This study aimed to evaluate the benefit of probiotic in reducing the duration of acute diarrhea in adults as compared to placebo. Systematic search was done using four databases: PubMed, Scopus, ProQuest, and Embase, without limit on the year of publication. Randomized clinical trials were selected as the appropriate study design to answer the clinical question and two studies were considered relevant for appraisal. In conclusion, probiotics could improve the recovery of acute infectious diarrhea in adults (level of evidence 1b) however more studies should be carried out since only very few strains of probiotics have been investigated. Normal 0 false false false IN X-NONE X-NONE