Diarrhea in Preschool Children and Lactobacillus reuteri: A Randomized Controlled Trial
- 2014-04-01
- Pediatrics 133(4)
- P. Gutiérrez-Castrellón
- G. López-Velázquez
- Luisa Díaz-García
- C. Jiménez-Gutiérrez
- J. Mancilla-Ramírez
- Juliana Estevez-Jiménez
- M. Parra
- PubMed: 24639271
- DOI: 10.1542/peds.2013-0652
Abstract
Objectives: To evaluate whether daily administration of Lactobacillus reuteri DSM 17938 reduces the frequency and duration of diarrheal episodes and other health outcomes in day school children in Mexico.
Methods: Healthy children (born at term, aged 6-36 months) attending day care centers were enrolled in this randomized, double-blind, placebo-controlled trial. They received L reuteri DSM 17938 (dose 10(8) colony-forming unit; n = 168) or identical placebo (n = 168) by mouth, daily for 3 months, after which they were followed-up after a further 3 months without supplementation.
Results: Data from all children were included in the final analysis. 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). Additionally, the number of doctor visits, antibiotic use, absenteeism from day school and parental absenteeism from work were significantly reduced in the L reuteri group (P < .05). A cost-benefit analysis revealed significant reductions in costs in the L reuteri-treated children. No adverse events related to the study product were reported.
Conclusions: In healthy children attending day care centers, daily administration of L reuteri DSM 17938 had a significant effect in reducing episodes and duration of diarrhea and respiratory tract infection, with consequent cost savings for the community.
Trial registration: ClinicalTrials.gov NCT01249911.
Keywords: Lactobacillus reuteri DSM 17938; children; diarrhea.
Research Insights
| Supplement | Health Outcome | Effect Type | Effect Size |
|---|---|---|---|
| Lactobacillus reuteri | Reduced Antibiotic Usage | Beneficial | Large |
| Lactobacillus reuteri | Reduced Diarrhea Frequency | Beneficial | Large |
| Lactobacillus reuteri | Reduced Doctor Visits | Beneficial | Large |
| Lactobacillus reuteri | Reduced Duration of Diarrhea | Beneficial | Large |
| Lactobacillus reuteri | Reduced Frequency of Respiratory Tract Infections | Beneficial | Large |
| Lactobacillus reuteri | Reduced Parental Absenteeism from Work | Beneficial | Moderate |
| Lactobacillus reuteri | Reduced School Absenteeism Due to Infectious Diseases | Beneficial | Moderate |
| Lactobacillus reuteri DSM 17938 | Reduced Antibiotic Usage | Beneficial | Large |
| Lactobacillus reuteri DSM 17938 | Reduced Diarrhea Frequency | Beneficial | Large |
| Lactobacillus reuteri DSM 17938 | Reduced Doctor Visits | Beneficial | Large |
| Lactobacillus reuteri DSM 17938 | Reduced Duration of Diarrhea | Beneficial | Large |
| Lactobacillus reuteri DSM 17938 | Reduced Duration of Respiratory Tract Infections | Beneficial | Large |
| Lactobacillus reuteri DSM 17938 | Reduced Frequency of Respiratory Tract Infections | Beneficial | Large |
| Lactobacillus reuteri DSM 17938 | Reduced Parental Absenteeism from Work | Beneficial | Moderate |
| Lactobacillus reuteri DSM 17938 | Reduced School Absenteeism Due to Infectious Diseases | Beneficial | Moderate |
| Lactobacillus reuteri HA-188 | Reduced Antibiotic Usage | Beneficial | Large |
| Lactobacillus reuteri HA-188 | Reduced Diarrhea Incidence | Beneficial | Large |
| Lactobacillus reuteri HA-188 | Reduced Doctor Visits | Beneficial | Large |
| Lactobacillus reuteri HA-188 | Reduced Healthcare Costs | Beneficial | Large |
| Lactobacillus reuteri HA-188 | Reduced Parental Absenteeism from Work | Beneficial | Moderate |
| Lactobacillus reuteri HA-188 | Reduced Respiratory Tract Infection Episodes | Beneficial | Large |
| Lactobacillus reuteri HA-188 | Reduced School Absenteeism Due to Infectious Diseases | Beneficial | Moderate |
| Lactobacillus reuteri NCIMB 30242 | Reduced Antibiotic Usage | Beneficial | Large |
| Lactobacillus reuteri NCIMB 30242 | Reduced Community Healthcare Costs | Beneficial | Moderate |
| Lactobacillus reuteri NCIMB 30242 | Reduced Doctor Visits | Beneficial | Large |
| Lactobacillus reuteri NCIMB 30242 | Reduced Parental Absenteeism from Work | Beneficial | Moderate |
| Lactobacillus reuteri NCIMB 30242 | Reduced School Absenteeism Due to Infectious Diseases | Beneficial | Moderate |
| Lactobacillus reuteri Osfortis | Reduced Antibiotic Usage | Beneficial | Large |
| Lactobacillus reuteri Osfortis | Reduced Doctor Visits | Beneficial | Large |
| Lactobacillus reuteri Osfortis | Reduced Healthcare Costs | Beneficial | Large |
| Lactobacillus reuteri SD-5865 | Reduced Antibiotic Usage | Beneficial | Large |
| Lactobacillus reuteri SD-5865 | Reduced Community Healthcare Costs | Beneficial | Moderate |
| Lactobacillus reuteri SD-5865 | Reduced Doctor Visits | Beneficial | Large |
| Lactobacillus reuteri SD-5865 | Reduced Parental Absenteeism from Work | Beneficial | Moderate |
| Lactobacillus reuteri SD-5865 | Reduced School Absenteeism Due to Infectious Diseases | Beneficial | Moderate |
| Lactobacillus reuteri UALg-05 | Reduced Antibiotic Usage | Beneficial | Large |
| Lactobacillus reuteri UALg-05 | Reduced Community Healthcare Costs | Beneficial | Moderate |
| Lactobacillus reuteri UALg-05 | Reduced Diarrhea Frequency | Beneficial | Large |
| Lactobacillus reuteri UALg-05 | Reduced Duration of Diarrhea | Beneficial | Large |
| Lactobacillus reuteri UALg-05 | Reduced Duration of Respiratory Tract Infections | Beneficial | Large |
| Lactobacillus reuteri UALg-05 | Reduced Frequency of Respiratory Tract Infections | Beneficial | Large |
| Lactobacillus reuteri UALg-05 | Reduced Parental Absenteeism from Work | Beneficial | Moderate |
| Lactobacillus reuteri UALg-05 | Reduced School Absenteeism Due to Infectious Diseases | Beneficial | Moderate |
| Lactobacillus reuteri UALre-16 | Reduced Antibiotic Usage | Beneficial | Large |
| Lactobacillus reuteri UALre-16 | Reduced Community Healthcare Costs | Beneficial | Moderate |
| Lactobacillus reuteri UALre-16 | Reduced Parental Absenteeism from Work | Beneficial | Moderate |
| Lactobacillus reuteri UALre-16 | Reduced School Absenteeism Due to Infectious Diseases | Beneficial | Moderate |