Systematic review with meta-analysis: Lactobacillus reuteri DSM 17938 for diarrhoeal diseases in children.

2016-03-16
Alimentary pharmacology & therapeutics 43(10)
- M Urbańska
- D Gieruszczak-Białek
- H Szajewska

PubMed: 26991503
DOI: 10.1111/apt.13590

Study Design

Type: Meta-Analysis
Sample size: n = 1,229
Population: children
Methods: Medline, Embase, the Cochrane Library, trial registries and reference lists of included studies were searched in January 2016, with no language restriction, for randomised controlled trials (RCTs)
Funding: Unclear

Rigorous Journal

Background

Not all probiotics are equal.

Aim

To investigate the efficacy of Lactobacillus reuteri DSM 17938 (L. reuteri) in the management of various types of diarrhoeal diseases in children.

Methods

Medline, Embase, the Cochrane Library, trial registries and reference lists of included studies were searched in January 2016, with no language restriction, for randomised controlled trials (RCTs).

Results

Eight RCTs (n = 1229) met the inclusion criteria. In treatment trials, L. reuteri administration reduced the duration of diarrhoea (three RCTs, n = 256, mean difference, MD -24.82 h, 95% CI -38.8 to -10.8) and increased the cure rate on day 1 and day 2. However, heterogeneity and wide confidence intervals call for caution in interpreting results. In preventive trials carried out in hospitalised children, based on the findings from two RCTs (n = 290), there was no significant reduction in the risk of nosocomial diarrhoea, rotavirus diarrhoea or diarrhoea of any origin with L. reuteri administration. Based on one RCT (n = 97), there was no effect of L. reuteri on the risk of antibiotic-associated diarrhoea. However, the evidence is limited because the overall frequency of diarrhoea was surprisingly low. In preventive studies carried out in apparently healthy children, L. reuteri reduced diarrhoeal outcomes in one RCT; the evidence from another trial was less convincing.

Conclusions

In therapeutic settings, L. reuteri administration reduces the duration of diarrhoea and increases the chance of cure. In preventive settings, L. reuteri has the potential to reduce the risk of community-acquired diarrhoea in otherwise healthy children.

Research Insights

Lactobacillus reuteri DSM 17938→Increased Cure Rate
increased the cure rate on day 1 and day 2
Effect
Beneficial
Effect size
Small
Lactobacillus reuteri DSM 17938→Reduced Diarrhea Rate
L. reuteri reduced diarrhoeal outcomes in one RCT; the evidence from another trial was less convincing
Effect
Beneficial
Effect size
Small

Adverse Events Reported

Lactobacillus reuteri DSM 17938→Overall tolerability
The study does not report any adverse events or side effects associated with L. reuteri administration.
Finding
Reported