Enteroadsorbent Polymethylsiloxane Polyhydrate vs. Probiotic Lactobacillus reuteri DSM 17938 in the Treatment of Rotaviral Gastroenteritis in Infants and Toddlers, a Randomized Controlled Trial

Abstract

Purpose: The aim of this study was to compare two adjunct therapies in the treatment of childhood rotavirus gastroenteritis (RVGE). We compared the recommended treatment, probiotic Lactobacillus reuteri DSM 17938 (BioGaia®), vs. a novel treatment, enterosorbent polymethylsiloxane polyhydrate (Enterosgel®).Methods: This was an open-label, randomized, clinical controlled trial at the University Hospital for Infectious Diseases (UHID) in Zagreb, Croatia. A total of 149 children aged 6–36 months with acute rotaviral gastroenteritis over a period of <48 h, with no significant chronic comorbidity, were randomized to receive the standard therapy with L. reuteri DSM 17938 (hereafter L. reuteri) or polymethylsiloxane polyhydrate (hereafter PMSPH) therapy, during 5 days. The primary end point was time to recovery in days in both groups. The recovery was defined as absence of fever and vomiting and either the first firm stool, absence of stool for more than 24 h, or return of usual bowel habit.Results: A total of 75 children were randomized into the L. reuteri group and 74 were randomized into the PMSPH group; after excluding missing data, the data from 65 children in each group were analyzed. There was no significant difference in the treatment efficacy between the two regimens with an estimated median time of recovery of 6 days in both groups (p = 0.754). No significant side effects were observed in either group.Conclusion: Novel enterosorbent PMSPH had a similar efficacy to probiotic L. reuteri in the treatment of rotaviral gastroenteritis in preschool children.Clinical Trial Registration:ClinicalTrials.gov Identifier: NCT04116307 [October 3, 2019] (retrospectively registered). https://clinicaltrials.gov/show/NCT04116307.

Role of Multistrain Probiotic as Supportive Therapy in Reducing the Frequency and Severity of Respiratory Infections in Children

“…In our research, probiotics were administered three hours after IV administration of antibiotics to evade the effect of antibiotics on probiotics. [13][14] . They improved in 36.6% of subjects compare with only 5.8% in the group of placebo.…”

Enterosorbents in complex therapy of food allergies: a focus on digestive disorders and systemic toxicity in children

“…The clinical efficacy of some enterosorbents in mild and moderate forms of intestinal infections is not inferior to antibiotics (32). Effectiveness of enterosorption is comparable to the use of probiotics (120,121).…”

“…Experience with this type of treatment, mainly in post-Soviet countries, has shown the feasibility of its use in the acute period of allergic diseases and to prevent recurrence of the disease. Today, enterosorption is a component of complex therapy for various types of intoxication, including allergic, with a scientifically based and clinically proven efficacy (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(111)(112)(113)(114)(115)(116)(117)(118)(119)(120)(121)(122)(123)(124)(125).…”

“…Both conditions have the same molecular formula but differ in structural arrangement (133,134). The lattices of crystalline silica are arranged regularly, while the lattices of amorphous silica are arranged irregularly (121)(122)(123)(124)(125)(126)(127)(128)(129)(130)(131)(132)(133)(134)(135)(136)(137)(138)(139).…”