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Meta-analysis: Lactobacillus reuteri strain DSM 17938 (and the original strain ATCC 55730) for treating acute gastroenteritis in children.

  • 2014-09-01
  • Beneficial Microbes 5(3)
    • H. Szajewska
    • Magdalena Urbańska
    • A. Chmielewska
    • Zvi Weizman
    • R. Shamir

Abstract

Lactobacillus reuteri ATCC 55730 has been shown to provide a moderate clinical effect in the treatment of acute gastroenteritis (AGE) in children. However, as the L. reuteri ATCC 55730 strain was found to carry potentially transferable resistance traits for tetracycline and lincomycin, it was replaced by a new strain, L. reuteri DSM 17938, without unwanted plasmid-borne antibiotic resistance. Bioequivalence of the two strains has been suggested. We aimed to systematically evaluate data on the effectiveness of L. reuteri DSM 17938 and the original strain, L. reuteri ATCC 55730, in the treatment of AGE in children. The Cochrane Library, MEDLINE, and EMBASE databases, reference lists, and abstract books of major scientific meetings were searched in August 2013, with no language restrictions, for relevant randomised controlled trials (RCTs). Two RCTs (n=196) that evaluated L. reuteri DSM 17938 and three RCTs (n=156) that evaluated L. reuteri ATCC 55730, which involved hospitalised children aged 3 to 60 months, met the inclusion criteria. Compared with placebo or no treatment, DSM 17938 significantly reduced the duration of diarrhoea (mean difference -32 h, 95% confidence interval (CI): -41 to -24) and increased the chance of cure on day 3 (relative risk: 3.5, 95% CI: 1.2 to 10.8, random effects model). Similar results were obtained with the original strain, L. reuteri ATCC 55730. In conclusion, in hospitalised children, use of both strains of L. reuteri reduced the duration of diarrhoea, and more children were cured within 3 days. Data from outpatients and countryspecific cost-effectiveness analyses are needed. Given the limited data and the methodological limitations of the included trials, the evidence should be viewed with caution.

Keywords: L. reuteri; RCT; diarrhoea; infants; microbiota; probiotics; systematic review.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus reuteriIncreased Cure Rate on Day 3 for AGEBeneficial
Moderate
Lactobacillus reuteriReduced Duration of DiarrheaBeneficial
Large
Lactobacillus reuteri DSM 17938Improved Cure Rate on Day 3Beneficial
Large
Lactobacillus reuteri DSM 17938Reduced Duration of DiarrheaBeneficial
Large
Lactobacillus reuteri LRE02Improved Cure Rate on Day 3Beneficial
Large
Lactobacillus reuteri LRE02Reduced Duration of DiarrheaBeneficial
Large
Lactobacillus reuteri MAK02L14RIncreased Cure RateBeneficial
Moderate
Lactobacillus reuteri MAK02L14RReduced Duration of DiarrheaBeneficial
Large
Lactobacillus reuteri OsfortisAccelerated Recovery within 3 DaysBeneficial
Large
Lactobacillus reuteri OsfortisImproved Cure Rate on Day 3Beneficial
Large
Lactobacillus reuteri OsfortisReduced Duration of DiarrheaBeneficial
Large
Lactobacillus reuteri SD-5865Improved Cure Rate on Day 3Beneficial
Large
Lactobacillus reuteri SD-5865Reduced Duration of DiarrheaBeneficial
Large
Lactobacillus reuteri UALre-16Increased Cure Rate of Diarrhea by Day 3Beneficial
Moderate
Lactobacillus reuteri UALre-16Reduced Duration of DiarrheaBeneficial
Large
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