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Bacteriotherapy with Lactobacillus reuteri in rotavirus gastroenteritis.

  • 1997-12
  • The Pediatric Infectious Disease Journal 16(12)
    • Aino-Vieno Shornikova
    • I. Casas
    • H. Mykkänen
    • E. Salo
    • T. Vesikari

Abstract

Background: Certain lactic acid bacteria may accelerate recovery from acute diarrhea. Lactobacillus reuteri is a commonly occurring Lactobacillus species with therapeutic potential in diarrhea.

Design: Prospective, randomized, placebo-controlled trial in two hospitals.

Methods: Children between 6 and 36 months of age admitted for rotavirus-associated diarrhea were randomized into three groups to receive either 10(10) or 10(7) colony-forming units (cfu) of L. reuteri or a matching placebo once a day for up to 5 days.

Results: The main effect of L. reuteri was on the duration of watery diarrhea. The mean (+/-SD) duration of watery diarrhea after initiation of treatment was 2.5 (1.5) days in the placebo group (n = 25) vs. 1.9 (0.9) days in the small dosage (n = 20) and 1.5 (1.1) days in the large dosage (n = 21) L. reuteri recipients (P = 0.01). By the second day of treatment watery diarrhea persisted in 80% of the placebo, 70% of the small dosage and 48% of the large dosage L. reuteri recipients (P = 0.04, large dosage vs. placebo). Stool cultures for lactobacilli confirmed that administration of L. reuteri resulted in good colonization of the GI tract. The mean (+/-SD) of total Lactobacillus count 2 days after treatment initiation was 2.8 (1.6) log 10 cfu/g in the placebo group, 4.5 (2.0) log 10 cfu/g in the small dosage L. reuteri group and 6.1 (1.2) log 10 cfu/g in the large dosage L. reuteri group (P = 0.0004).

Conclusions: L. reuteri effectively colonized the gastrointestinal tract after administration and significantly shortened the duration of watery diarrhea associated with rotavirus. There was a correlation between the dosage of L. reuteri and the clinical effect.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus reuteri OsfortisIncreased Fecal Lactobacillus CountBeneficial
Large
Lactobacillus reuteri OsfortisReduced Duration of Diarrhea SymptomsBeneficial
Moderate
Lactobacillus reuteri SD-5865Increased Gastrointestinal Tract Colonization by LactobacilliBeneficial
Large
Lactobacillus reuteri SD-5865Reduced Duration of Watery DiarrheaBeneficial
Moderate
Lactobacillus reuteri UALg-05Improved Colonization of Gastrointestinal Tract by LactobacilliBeneficial
Large
Lactobacillus reuteri UALg-05Reduced Duration of Diarrhea SymptomsBeneficial
Moderate

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