title: A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children.
abstract: 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.
authors.affiliation: Asociacion Benefica PRISMA, 251 Avenida Carlos Gonzalez, Urb. Maranga, San Miguel, Lima, Peru.
authors.forename: R A
authors.initials: RA
authors.lastname: Oberhelman
authors.forename: R H
authors.initials: RH
authors.lastname: Gilman
authors.forename: P
authors.initials: P
authors.lastname: Sheen
authors.forename: D N
authors.initials: DN
authors.lastname: Taylor
authors.forename: R E
authors.initials: RE
authors.lastname: Black
authors.forename: L
authors.initials: L
authors.lastname: Cabrera
authors.forename: A G
authors.initials: AG
authors.lastname: Lescano
authors.forename: R
authors.initials: R
authors.lastname: Meza
authors.forename: G
authors.initials: G
authors.lastname: Madico
mesh_terms: 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