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