Across 8 studies, 5 reported beneficial effects of Lactobacillus reuteri DSM 17938 on reducing diarrhea rate, predominantly with small to moderate effect sizes. The most consistent evidence comes from children with acute gastroenteritis, including a meta-analysis showing a reduction in diarrhea duration. However, 3 neutral findings indicate the effect is not universal, particularly in some acute gastroenteritis and prevention contexts.
Caveats: Available evidence is overwhelmingly positive (5 of 8 studies beneficial, 5 statistically significant) — clinical literature in this area is subject to publication bias (null-result studies are less likely to be published or indexed). Two trials with higher doses and larger sample sizes showed neutral results, suggesting the effect may be smaller or more context-dependent than the early positive studies suggest. Most studies were conducted in pediatric populations with acute diarrhea, limiting generalizability to adults or other indications.
Adverse events were similar in both groups.
from: Lack of Efficacy of Lactobacillus reuteri DSM 17938 for the Treatment of Acute Gastroentershowing a significant decrease of antibiotic-associated side effects and a tendency to increase the eradication rate
from: Use of Limosilactobacillus reuteri DSM 17938 in paediatric gastrointestinal disorders: anL. reuteri DSM 17938 is effective, safe, and well-tolerated in outpatient children with acute infectious diarrhea.
from: Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatieThis study shows that L. reuteri DSM 17938 is effective in decreasing frequency and consistency of stools; and is safe at high doses in patients from 1 month to 5 years of age
from: Lactobacillus reuteri protectis DSM 17938 at high doses versus placebo in children with acNo adverse events related to the study product were reported.
from: Diarrhea in Preschool Children and Lactobacillus reuteri: A Randomized Controlled Trialall these studies have shown the excellent safety of LR DSM 17938 even at higher dosages.
from: Use of Limosilactobacillus reuteri DSM 17938 in paediatric gastrointestinal disorders: anNo persistent diarrhoea or severe adverse effects were observed in both groups.
from: Efficacy of Lactobacillus reuteri DSM 17938 in Thai children with acute gastroenteritis anNo adverse effects related to L. reuteri were noted.
from: Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatieCompared 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 DSM 17938 significantly reduced the frequency and duration of episodes of diarrhea and respiratory tract infection at both 3 and 6 months (P < .05).
Watery diarrhea persisted in 58.6% in group 2 and in 19.4% of group 1 at 5 days of treatment.
The duration of diarrhea after randomization in both groups was similar (P = 0.6).
The percentage of participants who recovered within 48 h was significantly higher in the L. reuteri group (65.2%) compared to the control group (36.0%) [relative risk (RR) 3.33, 95% confidence interval (CI) 1.02-10.89, P-value = .043].
From the 72nd hour of intervention onwards, there was no difference between the two groups in the percentage of children with diarrhea.
Similar results were obtained with the original strain, L. reuteri ATCC 55730
does not seem to prevent nosocomial diarrhoea and antibiotic-associated diarrhoea