Probiotics in the treatment of acute rotavirus diarrhoea. A randomized, double-blind, controlled trial using two different probiotic preparations in Bolivian children

Abstract

BackgroundEvidence suggests that probiotics reduce rotavirus diarrhoea duration. Although there are several probiotic strains potentially useful, daily practice is often limited by the type and number of products locally available. In general, information about combined products is scarce. In this study we compare the effect of two probiotic products in the treatment of diarrhoea in children less than 2 years of age.MethodsA Randomized double-blind controlled clinical trial in children hospitalized for acute rotavirus diarrhoea, in the Paediatric Centre Albina Patino, Cochabamba, Bolivia.Participants were children aged 1 - 23 months, who were randomly assigned to receive one of three treatments: Oral rehydration therapy plus placebo; Oral rehydration solution plus Saccharomyces boulardii; or Oral rehydration solution plus a compound containing Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium longum and Saccharomyces boulardii. Sample size was 20 per group and the outcomes were duration of diarrhoea, of fever, of vomiting and of hospitalization.Results64 cases finished the protocol. On admission, patients' characteristics were similar. Median duration of diarrhoea (p = 0.04) in children who received the single species product (58 hours) was shorter than in controls (84.5 hrs). Comparing children that received the single probiotic product and controls showed shorter duration of fever (18 vs 67 hrs) (p = 0.0042) and the mixed probiotic of vomiting (0 vs 42.5 hrs) (p = 0.041). There was no effect on duration of hospitalization (p = 0.31). When experimental groups were merged, statistical significance of changes increased (total duration of diarrhoea, fever and vomiting P = 0.025, P = 0.025 and P = 0.014, respectively).ConclusionsBoth products decreased the duration of diarrhoea compared to oral rehydration solution alone. This decrease was significant only for the single species product which also decreased the duration of fever. With the multiple species product there was no vomiting subsequent to the initiation of treatment. The quantity of probiotic bacteria needed for optimum treatment of gastroenteritis remains to be determined, particularly when multiple species are included in the product.Trial registration: ClinicalTrials.gov ID: NCT00981877Link: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol/sid/S0002653/selectaction/View/ts/2/uid/U0000N04Trial RegistrationClinical trials NCT ID: NCT00981877

Effect of a single dose of Saccharomyces cerevisiae var. boulardii on the occurrence of porcine neonatal diarrhoea

“…SB has known positive effects on reduction of enteric pathogens of pigs including Escherichia coli (Lessard et al, 2008;Collier et al, 2011), and in human studies C. difficileassociated disease, and rotavirus infection (McFarland, 2006;Grandy et al, 2010); however, we found no evidence of such effects (data not shown). Not all diarrhoea is caused by infectious agents; thus, the significant reduction in diarrhoea in this study, related to SB administration, could be due to the physiological effects of SB improving osmotic balance.…”

“…boulardii is a non-pathogenic, non-colonising, yeast. Several studies have shown that, in humans, SB is an efficacious and safe probiotic, which has proven efficacy against some enteric diseases including, but not limited to, Clostridium difficile-associated disease and rotavirus diarrhoea (McFarland, 2006;Grandy et al, 2010;McFarland, 2010). Data on the effect of SB on neonatal porcine health are limited, possibly because of practical limitations of administration to individual neonates commercially; however, studies have demonstrated that SB supplementation improves growth in post-weaning pigs (Bontempo et al, 2006;Le Bon et al, 2010).…”

The role of Bifidobacterium lactis B94 plus inulin in the treatment of acute infectious diarrhea in children

“…The authors concluded that there is insufficient evidence to recommend L. acidophilus strain LB for treating diarrhea in children (24). Some studies also examined the effect of AGE treatment using other Lactobacillus species, some Bifidobacterium species, Streptococcus thermophilus, and other probiotics (25)(26)(27)(28). However, there is not enough evidence to recommend these probiotics for routine use in AGE (6).…”

Probiotics and Periodontal Diseases

“…The discovery of Lactic Acid Bacteria (LAB) in the middle of the nineteenth century confirmed the interest in microorganism and since then many people have concluded that dairy fermented by lactobacillales provide numerous benefits to our health [2].…”

“…The discovery of a symbiotic relationship between bacteria and humans awoke the curiosity of seeing the bacteria as potentially beneficial rather than pathogenic [2].…”