Cochrane Review: Probiotics for treating acute infectious diarrhoea
Identifieur interne : 002E67 ( Istex/Corpus ); précédent : 002E66; suivant : 002E68Cochrane Review: Probiotics for treating acute infectious diarrhoea
Auteurs : Stephen J. Allen ; Elizabeth G. Martinez ; Germana V. Gregorio ; Leonila F. DansSource :
- Evidence‐Based Child Health: A Cochrane Review Journal [ 1557-6272 ] ; 2011-11.
English descriptors
- KwdEn :
- Acidophilus, Acute diarrhea, Acute diarrhoea, Adult mortality, Adverse events, Allocation concealment, Analysis comparison, Antibiotic, Bacterial diarrhoea, Basu, Bias item authors, Blinding, Bloody diarrhoea, Boudraa, Boulardii, Buydens, Canani, Casei, Casei strain, Centre, Centre duration, Chi2, Child health, Cochrane, Cochrane collaboration, Concealment, Control group, Copyright, Dehydration, Diarrhoea, Diarrhoea comparison, Diarrhoeal, Difference weight, Enterococcus, Exclusion criteria, Favour, Favours control, Funding, Gastroenterology, Guandalini, Guarino, Henker, Heterogeneity, High child, Hydration, Hydration status, Identical placebo, Incomplete outcome data, Inpatient, Isolauri, Jasinski, John wiley sons, Judgement, Judgement description, Khanna, Kurugol, Lactic, Lactobacillus, Methods randomized, Mortality stratum, Narayanappa, Notes study location, Nutritional status, Oandasan, Open study, Outcome data, Outpatient, Overall effect, Pant, Participant, Participants inclusion criteria, Pathogen, Pediatric, Pediatric gastroenterology, Pediatrics, Placebo, Placebo group, Probiotic, Probiotic group, Rafeey, Randomization, Randomized, Rehydration, Rhamnosus, Risk ratio, Rosenfeldt, Rotavirus, Rotavirus diarrhoea, Saccharomyces, Saccharomyces boulardii, Sachet, Sequence generation, Severe dehydration, Severe malnutrition, Shornikova, Simakachorn, Single organism, Stool, Stool frequency, Subgroup, Subtotal, Szajewska, Szymanski, Tau2, Tau2 chi2, Teran, Uids, Unclear, Vivatvakin, Watery stools, Weight gain, Yogurt.
- Teeft :
- Acidophilus, Acute diarrhea, Acute diarrhoea, Adult mortality, Adverse events, Allocation concealment, Analysis comparison, Antibiotic, Bacterial diarrhoea, Basu, Bias item authors, Blinding, Bloody diarrhoea, Boudraa, Boulardii, Buydens, Canani, Casei, Casei strain, Centre, Centre duration, Chi2, Child health, Cochrane, Cochrane collaboration, Concealment, Control group, Copyright, Dehydration, Diarrhoea, Diarrhoea comparison, Diarrhoeal, Difference weight, Enterococcus, Exclusion criteria, Favour, Favours control, Funding, Gastroenterology, Guandalini, Guarino, Henker, Heterogeneity, High child, Hydration, Hydration status, Identical placebo, Incomplete outcome data, Inpatient, Isolauri, Jasinski, John wiley sons, Judgement, Judgement description, Khanna, Kurugol, Lactic, Lactobacillus, Methods randomized, Mortality stratum, Narayanappa, Notes study location, Nutritional status, Oandasan, Open study, Outcome data, Outpatient, Overall effect, Pant, Participant, Participants inclusion criteria, Pathogen, Pediatric, Pediatric gastroenterology, Pediatrics, Placebo, Placebo group, Probiotic, Probiotic group, Rafeey, Randomization, Randomized, Rehydration, Rhamnosus, Risk ratio, Rosenfeldt, Rotavirus, Rotavirus diarrhoea, Saccharomyces, Saccharomyces boulardii, Sachet, Sequence generation, Severe dehydration, Severe malnutrition, Shornikova, Simakachorn, Single organism, Stool, Stool frequency, Subgroup, Subtotal, Szajewska, Szymanski, Tau2, Tau2 chi2, Teran, Uids, Unclear, Vivatvakin, Watery stools, Weight gain, Yogurt.
Abstract
Probiotics may offer a safe intervention in acute infectious diarrhoea to reduce the duration and severity of the illness.
Url:
DOI: 10.1002/ebch.873
Links to Exploration step
ISTEX:8E411240135E835BFCBCDDC372299704AF228C21Le document en format XML
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Martinez</name><affiliation><mods:affiliation>Department of Pediatrics, University of the Philippines College of Medicine, Manila, Philippines</mods:affiliation></affiliation></author><author><name sortKey="Gregorio, Germana V" sort="Gregorio, Germana V" uniqKey="Gregorio G" first="Germana V" last="Gregorio">Germana V. Gregorio</name><affiliation><mods:affiliation>Department of Pediatrics, University of the Philippines College of Medicine, Manila, Philippines</mods:affiliation></affiliation></author><author><name sortKey="Dans, Leonila F" sort="Dans, Leonila F" uniqKey="Dans L" first="Leonila F" last="Dans">Leonila F. 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Grove Building, Singleton Park, Swansea, West Glamorgan, SA2 8PP, UK.</json:string></affiliations></json:item><json:item><name>Elizabeth G Martinez</name><affiliations><json:string>Department of Pediatrics, University of the Philippines College of Medicine, Manila, Philippines</json:string></affiliations></json:item><json:item><name>Germana V Gregorio</name><affiliations><json:string>Department of Pediatrics, University of the Philippines College of Medicine, Manila, Philippines</json:string></affiliations></json:item><json:item><name>Leonila F Dans</name><affiliations><json:string>Departments of Pediatrics and Clinical Epidemiology, University of the Philippines College of Medicine, Manila, Philippines</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Acute Disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Diarrhea [microbiology; parasitology; 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Review</value></json:item></subject></host><publicationDate>2011</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1002/ebch.873</json:string></doi><id>8E411240135E835BFCBCDDC372299704AF228C21</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/8E411240135E835BFCBCDDC372299704AF228C21/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/8E411240135E835BFCBCDDC372299704AF228C21/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/8E411240135E835BFCBCDDC372299704AF228C21/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Cochrane Review: Probiotics for treating acute infectious diarrhoea</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>BP, UK</pubPlace><availability><licence>Copyright © 2010 John Wiley & Sons, Ltd.</licence></availability><date type="published" when="2011-11"></date></publicationStmt><notesStmt><note type="content-type" subtype="other" source="miscellaneous" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-7474895G-0">other</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="other"><analytic><title level="a" type="main" xml:lang="en">Cochrane Review: Probiotics for treating acute infectious diarrhoea</title><title level="a" type="short" xml:lang="en">Probiotics for treating acute infectious diarrhoea</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">Stephen J</forename><surname>Allen</surname></persName><email>S.J.Allen@swansea.ac.uk</email><affiliation>School of Medicine, Swansea University, Swansea, UK<address><country key="GB"></country></address></affiliation><affiliation>School of Medicine, Swansea University, Room 314, The Grove Building, Singleton Park, Swansea, West Glamorgan, SA2 8PP, UK.</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Elizabeth G</forename><surname>Martinez</surname></persName><affiliation>Department of Pediatrics, University of the Philippines College of Medicine, Manila, Philippines<address><country key="PH"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Germana V</forename><surname>Gregorio</surname></persName><affiliation>Department of Pediatrics, University of the Philippines College of Medicine, Manila, Philippines<address><country key="PH"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Leonila F</forename><surname>Dans</surname></persName><affiliation>Departments of Pediatrics and Clinical Epidemiology, University of the Philippines College of Medicine, Manila, Philippines<address><country key="PH"></country></address></affiliation></author><idno type="istex">8E411240135E835BFCBCDDC372299704AF228C21</idno><idno type="ark">ark:/67375/WNG-83D9W3NC-W</idno><idno type="DOI">10.1002/ebch.873</idno><idno type="unit">EBCH873</idno><idno type="toTypesetVersion">file:EBCH.EBCH873.pdf</idno></analytic><monogr><title level="j" type="main">Evidence‐Based Child Health: A Cochrane Review Journal</title><title level="j" type="alt">EVIDENCE-BASED CHILD HEALTH: A COCHRANE REVIEW JOURNAL</title><idno type="pISSN">1557-6272</idno><idno type="eISSN">1557-6272</idno><idno type="book-DOI">10.1002/(ISSN)1557-6272</idno><idno type="book-part-DOI">10.1002/ebch.v6.6</idno><idno type="product">EBCH</idno><imprint><biblScope unit="vol">6</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1894">1894</biblScope><biblScope unit="page" to="2021">2021</biblScope><biblScope unit="page-count">128</biblScope><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>BP, UK</pubPlace><date type="published" when="2011-11"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head>
Background
<p>Probiotics may offer a safe intervention in acute infectious diarrhoea to reduce the duration and severity of the illness.</p>
Objectives
<p>To assess the effects of probiotics in proven or presumed acute infectious diarrhoea.</p>
Search strategy
<p>We searched the Cochrane Infectious Diseases Group's trials register (July 2010), the Cochrane Controlled Trials Register (<hi rend="italic">The Cochrane Library</hi> Issue 2, 2010), MEDLINE (1966 to July 2010), EMBASE (1988 to July 2010), and reference lists from studies and reviews. We also contacted organizations and individuals working in the field, and pharmaceutical companies manufacturing probiotic agents.</p>
Selection criteria
<p>Randomized and quasi‐randomized controlled trials comparing a specified probiotic agent with a placebo or no probiotic in people with acute diarrhoea that is proven or presumed to be caused by an infectious agent.</p>
Data collection and analysis
<p>Two reviewers independently assessed the methodological quality of the trial and extracted data. Primary outcomes were the mean duration of diarrhoea, stool frequency on day 2 after intervention and ongoing diarrhoea on day 4. A random‐effects model was used.</p>
Main results
<p>Sixty‐three studies met the inclusion criteria with a total of 8014 participants. Of these, 56 trials recruited infants and young children. The trials varied in the definition used for acute diarrhoea and the end of the diarrhoeal illness, as well as in the risk of bias. The trials were undertaken in a wide range of different settings and also varied greatly in organisms tested, dosage, and participants' characteristics. No adverse events were attributed to the probiotic intervention.</p><p>Probiotics reduced the duration of diarrhoea, although the size of the effect varied considerably between studies.</p><p>The average of the effect was significant for mean duration of diarrhoea (mean difference 24.76 hours; 95% confidence interval 15.9 to 33.6 hours; n=4555, trials=35) diarrhoea lasting ≥4 days (risk ratio 0.41; 0.32 to 0.53; n=2853, trials=29) and stool frequency on day 2 (mean difference 0.80; 0.45 to 1.14; n=2751, trials=20).</p><p>The differences in effect size between studies was not explained by study quality, probiotic strain, the number of different strains, the viability of the organisms, dosage of organisms, the causes of diarrhoea, or the severity of the diarrhoea, or whether the studies were done in developed or developing countries.</p>
Authors' conclusions
<p>Used alongside rehydration therapy, probiotics appear to be safe and have clear beneficial effects in shortening the duration and reducing stool frequency in acute infectious diarrhoea. However, more research is needed to guide the use of particular probiotic regimens in specific patient groups.</p>
Plain Language Summary
<p><hi rend="bold">Probiotics for treating acute infectious diarrhoea</hi></p><p>Episodes of acute infectious diarrhoea remain a major disease burden throughout the world, especially in developing countries. They are due to infection by many different organisms. Most episodes are self‐limiting and usually investigations are not done to identify the infectious agent. The main risk to health is dehydration and management aims to improve and maintain hydration status. However, rehydration fluids do not reduce the stool volume or shorten the episode of diarrhoea. Probiotics are "friendly" bacteria that improve health and are not harmful in themselves. A number of randomized controlled trials have been done to see whether probiotics are beneficial in acute infectious diarrhoea. We have searched for as many of these trials as possible and collected together the data in a systematic way to try to discover whether or not probiotics are beneficial in acute diarrhoea. We identified 63 trials, which included a total of 8014 people ‐ mainly infants and children. Probiotics were not associated with any adverse effects. Nearly all studies reported a shortened duration of diarrhoea and reduced stool frequency in people who received probiotics compared to the controls. Overall, probiotics reduced the duration of diarrhoea by around 25 hours, the risk of diarrhoea lasting four or more days by 59% and resulted in about one fewer diarrhoeal stool on day 2 after the intervention. However, there was very marked variability in the study findings and so these estimates are approximate. We concluded that these results were very encouraging but more research is needed to identify exactly which probiotics should be used for which groups of people, and also to assess the cost effectiveness of this treatment.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="kwd1">Acute Disease</term><term xml:id="kwd2">Diarrhea [microbiology; parasitology; *therapy]</term><term xml:id="kwd3">Probiotics [*therapeutic use]</term><term xml:id="kwd4">Adult</term><term xml:id="kwd5">Child</term><term xml:id="kwd6">Child, Preschool</term><term xml:id="kwd7">Humans</term><term xml:id="kwd8">Infant</term></keywords><keywords rend="articleCategory"><term>Cochrane Review</term></keywords><keywords rend="tocHeading1"><term>Probiotics for Acute Infectious Diarrhoea</term></keywords></textClass><langUsage><language 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number="162"></count></countGroup><titleGroup><title type="main" xml:lang="en">Cochrane Review: Probiotics for treating acute infectious diarrhoea</title><title type="short" xml:lang="en">Probiotics for treating acute infectious diarrhoea</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Stephen J</givenNames><familyName>Allen</familyName></personName><contactDetails><email>S.J.Allen@swansea.ac.uk</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Elizabeth G</givenNames><familyName>Martinez</familyName></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Germana V</givenNames><familyName>Gregorio</familyName></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Leonila F</givenNames><familyName>Dans</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="GB" type="organization"><unparsedAffiliation>School of Medicine, Swansea University, Swansea, UK</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="PH" type="organization"><unparsedAffiliation>Department of Pediatrics, University of the Philippines College of Medicine, Manila, Philippines</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="PH" type="organization"><unparsedAffiliation>Departments of Pediatrics and Clinical Epidemiology, University of the Philippines College of Medicine, Manila, Philippines</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Acute Disease</keyword><keyword xml:id="kwd2">Diarrhea [microbiology; parasitology; *therapy]</keyword><keyword xml:id="kwd3">Probiotics [*therapeutic use]</keyword><keyword xml:id="kwd4">Adult</keyword><keyword xml:id="kwd5">Child</keyword><keyword xml:id="kwd6">Child, Preschool</keyword><keyword xml:id="kwd7">Humans</keyword><keyword xml:id="kwd8">Infant</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Background</title><p>Probiotics may offer a safe intervention in acute infectious diarrhoea to reduce the duration and severity of the illness.</p></section><section xml:id="abs1-2"><title type="main">Objectives</title><p>To assess the effects of probiotics in proven or presumed acute infectious diarrhoea.</p></section><section xml:id="abs1-3"><title type="main">Search strategy</title><p>We searched the Cochrane Infectious Diseases Group's trials register (July 2010), the Cochrane Controlled Trials Register (<i>The Cochrane Library</i> Issue 2, 2010), MEDLINE (1966 to July 2010), EMBASE (1988 to July 2010), and reference lists from studies and reviews. We also contacted organizations and individuals working in the field, and pharmaceutical companies manufacturing probiotic agents.</p></section><section xml:id="abs1-4"><title type="main">Selection criteria</title><p>Randomized and quasi‐randomized controlled trials comparing a specified probiotic agent with a placebo or no probiotic in people with acute diarrhoea that is proven or presumed to be caused by an infectious agent.</p></section><section xml:id="abs1-5"><title type="main">Data collection and analysis</title><p>Two reviewers independently assessed the methodological quality of the trial and extracted data. Primary outcomes were the mean duration of diarrhoea, stool frequency on day 2 after intervention and ongoing diarrhoea on day 4. A random‐effects model was used.</p></section><section xml:id="abs1-6"><title type="main">Main results</title><p>Sixty‐three studies met the inclusion criteria with a total of 8014 participants. Of these, 56 trials recruited infants and young children. The trials varied in the definition used for acute diarrhoea and the end of the diarrhoeal illness, as well as in the risk of bias. The trials were undertaken in a wide range of different settings and also varied greatly in organisms tested, dosage, and participants' characteristics. No adverse events were attributed to the probiotic intervention.</p><p>Probiotics reduced the duration of diarrhoea, although the size of the effect varied considerably between studies.</p><p>The average of the effect was significant for mean duration of diarrhoea (mean difference 24.76 hours; 95% confidence interval 15.9 to 33.6 hours; n=4555, trials=35) diarrhoea lasting ≥4 days (risk ratio 0.41; 0.32 to 0.53; n=2853, trials=29) and stool frequency on day 2 (mean difference 0.80; 0.45 to 1.14; n=2751, trials=20).</p><p>The differences in effect size between studies was not explained by study quality, probiotic strain, the number of different strains, the viability of the organisms, dosage of organisms, the causes of diarrhoea, or the severity of the diarrhoea, or whether the studies were done in developed or developing countries.</p></section><section xml:id="abs1-7"><title type="main">Authors' conclusions</title><p>Used alongside rehydration therapy, probiotics appear to be safe and have clear beneficial effects in shortening the duration and reducing stool frequency in acute infectious diarrhoea. However, more research is needed to guide the use of particular probiotic regimens in specific patient groups.</p></section><section xml:id="abs1-8"><title type="main">Plain Language Summary</title><p><b>Probiotics for treating acute infectious diarrhoea</b></p><p>Episodes of acute infectious diarrhoea remain a major disease burden throughout the world, especially in developing countries. They are due to infection by many different organisms. Most episodes are self‐limiting and usually investigations are not done to identify the infectious agent. The main risk to health is dehydration and management aims to improve and maintain hydration status. However, rehydration fluids do not reduce the stool volume or shorten the episode of diarrhoea. Probiotics are "friendly" bacteria that improve health and are not harmful in themselves. A number of randomized controlled trials have been done to see whether probiotics are beneficial in acute infectious diarrhoea. We have searched for as many of these trials as possible and collected together the data in a systematic way to try to discover whether or not probiotics are beneficial in acute diarrhoea. We identified 63 trials, which included a total of 8014 people ‐ mainly infants and children. Probiotics were not associated with any adverse effects. Nearly all studies reported a shortened duration of diarrhoea and reduced stool frequency in people who received probiotics compared to the controls. Overall, probiotics reduced the duration of diarrhoea by around 25 hours, the risk of diarrhoea lasting four or more days by 59% and resulted in about one fewer diarrhoeal stool on day 2 after the intervention. However, there was very marked variability in the study findings and so these estimates are approximate. We concluded that these results were very encouraging but more research is needed to identify exactly which probiotics should be used for which groups of people, and also to assess the cost effectiveness of this treatment.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Cochrane Review: Probiotics for treating acute infectious diarrhoea</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Probiotics for treating acute infectious diarrhoea</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Cochrane Review: Probiotics for treating acute infectious diarrhoea</title></titleInfo><name type="personal"><namePart type="given">Stephen J</namePart><namePart type="family">Allen</namePart><affiliation>School of Medicine, Swansea University, Swansea, UK</affiliation><affiliation>E-mail: S.J.Allen@swansea.ac.uk</affiliation><affiliation>Correspondence address: School of Medicine, Swansea University, Room 314, The Grove Building, Singleton Park, Swansea, West Glamorgan, SA2 8PP, UK.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elizabeth G</namePart><namePart type="family">Martinez</namePart><affiliation>Department of Pediatrics, University of the Philippines College of Medicine, Manila, Philippines</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Germana V</namePart><namePart type="family">Gregorio</namePart><affiliation>Department of Pediatrics, University of the Philippines College of Medicine, Manila, Philippines</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Leonila F</namePart><namePart type="family">Dans</namePart><affiliation>Departments of Pediatrics and Clinical Epidemiology, University of the Philippines College of Medicine, Manila, Philippines</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="miscellaneous" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>John Wiley & Sons, Ltd.</publisher><place><placeTerm type="text">BP, UK</placeTerm></place><dateIssued encoding="w3cdtf">2011-11</dateIssued><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">24</extent><extent unit="tables">69</extent><extent unit="references">162</extent></physicalDescription><abstract>Probiotics may offer a safe intervention in acute infectious diarrhoea to reduce the duration and severity of the illness.</abstract><abstract>To assess the effects of probiotics in proven or presumed acute infectious diarrhoea.</abstract><abstract>We searched the Cochrane Infectious Diseases Group's trials register (July 2010), the Cochrane Controlled Trials Register (The Cochrane Library Issue 2, 2010), MEDLINE (1966 to July 2010), EMBASE (1988 to July 2010), and reference lists from studies and reviews. We also contacted organizations and individuals working in the field, and pharmaceutical companies manufacturing probiotic agents.</abstract><abstract>Randomized and quasi‐randomized controlled trials comparing a specified probiotic agent with a placebo or no probiotic in people with acute diarrhoea that is proven or presumed to be caused by an infectious agent.</abstract><abstract>Two reviewers independently assessed the methodological quality of the trial and extracted data. Primary outcomes were the mean duration of diarrhoea, stool frequency on day 2 after intervention and ongoing diarrhoea on day 4. A random‐effects model was used.</abstract><abstract>Sixty‐three studies met the inclusion criteria with a total of 8014 participants. Of these, 56 trials recruited infants and young children. The trials varied in the definition used for acute diarrhoea and the end of the diarrhoeal illness, as well as in the risk of bias. The trials were undertaken in a wide range of different settings and also varied greatly in organisms tested, dosage, and participants' characteristics. No adverse events were attributed to the probiotic intervention. Probiotics reduced the duration of diarrhoea, although the size of the effect varied considerably between studies. The average of the effect was significant for mean duration of diarrhoea (mean difference 24.76 hours; 95% confidence interval 15.9 to 33.6 hours; n=4555, trials=35) diarrhoea lasting ≥4 days (risk ratio 0.41; 0.32 to 0.53; n=2853, trials=29) and stool frequency on day 2 (mean difference 0.80; 0.45 to 1.14; n=2751, trials=20). The differences in effect size between studies was not explained by study quality, probiotic strain, the number of different strains, the viability of the organisms, dosage of organisms, the causes of diarrhoea, or the severity of the diarrhoea, or whether the studies were done in developed or developing countries.</abstract><abstract>Used alongside rehydration therapy, probiotics appear to be safe and have clear beneficial effects in shortening the duration and reducing stool frequency in acute infectious diarrhoea. However, more research is needed to guide the use of particular probiotic regimens in specific patient groups.</abstract><abstract>Probiotics for treating acute infectious diarrhoea Episodes of acute infectious diarrhoea remain a major disease burden throughout the world, especially in developing countries. They are due to infection by many different organisms. Most episodes are self‐limiting and usually investigations are not done to identify the infectious agent. The main risk to health is dehydration and management aims to improve and maintain hydration status. However, rehydration fluids do not reduce the stool volume or shorten the episode of diarrhoea. Probiotics are "friendly" bacteria that improve health and are not harmful in themselves. A number of randomized controlled trials have been done to see whether probiotics are beneficial in acute infectious diarrhoea. We have searched for as many of these trials as possible and collected together the data in a systematic way to try to discover whether or not probiotics are beneficial in acute diarrhoea. We identified 63 trials, which included a total of 8014 people ‐ mainly infants and children. Probiotics were not associated with any adverse effects. Nearly all studies reported a shortened duration of diarrhoea and reduced stool frequency in people who received probiotics compared to the controls. Overall, probiotics reduced the duration of diarrhoea by around 25 hours, the risk of diarrhoea lasting four or more days by 59% and resulted in about one fewer diarrhoeal stool on day 2 after the intervention. However, there was very marked variability in the study findings and so these estimates are approximate. We concluded that these results were very encouraging but more research is needed to identify exactly which probiotics should be used for which groups of people, and also to assess the cost effectiveness of this treatment.</abstract><subject lang="en"><genre>keywords</genre><topic>Acute Disease</topic><topic>Diarrhea [microbiology; parasitology; *therapy]</topic><topic>Probiotics [*therapeutic use]</topic><topic>Adult</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Humans</topic><topic>Infant</topic></subject><relatedItem type="host"><titleInfo><title>Evidence‐Based Child Health: A Cochrane Review Journal</title></titleInfo><titleInfo type="abbreviated"><title>Evid.‐Based Child Health</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>Cochrane Review</topic></subject><identifier type="ISSN">1557-6272</identifier><identifier type="eISSN">1557-6272</identifier><identifier type="DOI">10.1002/(ISSN)1557-6272</identifier><identifier type="PublisherID">EBCH</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>6</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>1894</start><end>2021</end><total>128</total></extent></part></relatedItem><identifier type="istex">8E411240135E835BFCBCDDC372299704AF228C21</identifier><identifier type="ark">ark:/67375/WNG-83D9W3NC-W</identifier><identifier type="DOI">10.1002/ebch.873</identifier><identifier type="ArticleID">EBCH873</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2010 John Wiley & Sons, Ltd.</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-L0C46X92-X">wiley</recordContentSource><recordOrigin>John Wiley & Sons, Ltd.</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/8E411240135E835BFCBCDDC372299704AF228C21/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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