In clinical practice, probiotics are often recommended for the treatment of patients with a wide range of diarrheal diseases, both in adults and children.
Acute infectious gastroenteritis in children is an important public health problem, especially in low-income countries where the disease causes significant neonatal mortality. Gastroenteritis is a much less common cause of childhood death in developed countries, but it remains a major public health problem associated with high morbidity and high medical costs.
Probiotics are also often recommended for acute diarrhea in children. Although these recommendations are largely based on the results of studies that had significant flaws or methodological problems.
Find out in the article on estet-portal.com about the features of the use of probiotics in the treatment of gastroenteritis.
Clinical trials of probiotics
In this regard, Dr. J. Thomas LaMont of the Department of Gastroenterology at Beth Israel Deaconess Medical Center (Boston, Massachusetts, USA), a teaching hospital for Harvard Medical School, reviewed the results of two recent double-blind randomized placebo-controlled trials in which researchers compared the efficacy of a probiotic with Lactobacillus rhamnosus and placebo in 1857 children with acute infectious gastroenteritis in Canada and the USA.
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The probiotics used in these two studies contained various strains of L. rhamnosus; in a Canadian study, a probiotic preparation was supplemented with a small amount of a probiotic strain of L. helveticus.
These drugs are available without a prescription and are also widely used for antibiotic-associated diarrhea and gastroenteritis in children and adults.
In both studies, neonates and children aged 3 to 48 months presenting to the emergency department with moderate to severe gastroenteritis were given standard therapy for acute gastroenteritis, including antibiotics (if indicated) plus a 5-day course of probiotics or placebo (drugs were identical in appearance).
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Efficacy of probiotics in gastroenteritis
The authors of both studies independently concluded that probiotics did not result in a reduction in overall clinical disease severity score 14 days after administration, suggesting that probiotics are no better than placebo. Moreover, one study did not find a significant difference in the duration of diarrhea and vomiting, the number of unscheduled visits to the doctor, or the duration of the disease in general.
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In both studies, side effect rates were similar between the probiotics and placebo groups.
Therefore, the results of the analyzed modern studies indicate the ineffectiveness of the use of probiotics containing L. rhamnosus and L. helveticus for the management of moderate to severe gastroenteritis in children.
Probiotics for Gastrointestinal Diseases
However, given the large number of probiotic preparations and their different mechanisms of action, their ability to colonize the gut, and perhaps their narrow potential for efficacy against specific diseases, the possibility remains that probiotics other than L. rhamnosus and L. helveticus may be effective in infectious diarrhea in children.
For example, the results of a recent large placebo-controlled study in rural India showed that probiotic prophylaxis containing L. plantarum in healthy newborns in the first 5 days of life resulted in a significant reduction in the incidence of sepsis and lower respiratory tract infections in the first 5 days of life. 2 months of life.
This specific probiotic strain compared to other probiotics, including L. rhamnosus, can colonize the intestinal tract for an extended period. This fact could explain its effectiveness in preventing sepsis up to 2 months after administration.
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Summarizing, the author of the analysis emphasized that due to their low cost and minimal toxicity, probiotics have the potential to treat patients with various gastrointestinal and other diseases, but rigorous clinical studies of these drugs are necessary to determine any potential effectiveness.
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