A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children.
OBJECTIVE
Lactobacillus GG (L-GG), an acid- and bile-resistant strain that colonizes the intestinal mucosa, has been used to manage diarrhea in children. Our objective was to evaluate the prophylactic use of L-GG to prevent diarrhea in children at high risk from a developing country in a randomized, placebo-controlled trial.


METHODS
Two hundred four undernourished children 6 to 24 months old from an indigent peri-urban Peruvian town received either L-GG or placebo in flavored gelatin once daily, 6 days a week, for 15 months. Episodes of diarrhea were documented by daily home visits, and diagnostic studies were done in a subset of cases. Recovery of L-GG in stool from subjects and from family contacts was examined.


RESULTS
Subjects in the L-GG group had significantly fewer episodes of diarrhea (5.21 episodes diarrhea/child/year ['ecy'] L-GG group, 6. 02 ecy placebo group; P =.028). The decreased incidence of diarrhea in the L-GG group was greatest in the 18- to 29-month age group (P =. 004) and was largely limited to nonbreastfed children (Breastfed: 6. 59 ecy L-GG, 6.32 ecy placebo, P =.7; Nonbreastfed: 4.69 ecy L-GG, 5. 86 ecy placebo, P =.005). The duration of diarrhea episodes and the causes of diarrhea were similar in both groups, except adenovirus was more common in the placebo group.


CONCLUSIONS
L-GG supplementation may be useful as a prophylactic measure to control diarrhea in undernourished children at increased risk, especially nonbreastfed children in the toddler age group.
Oberhelman
R A
RA
Asociacion Benefica PRISMA, 251 Avenida Carlos Gonzalez, Urb. Maranga, San Miguel, Lima, Peru.
Gilman
R H
RH
Sheen
P
P
Taylor
D N
DN
Black
R E
RE
Cabrera
L
L
Lescano
A G
AG
Meza
R
R
Madico
G
G
D001942:Breast Feeding; D015362:Child Nutrition Disorders; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D004311:Double-Blind Method; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007778:Lactobacillus; D016014:Linear Models; D008297:Male; D009752:Nutritional Status; D010568:Peru / Q000453:epidemiology; D011159:Population Surveillance; D019936:Probiotics