title: Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials.
abstract: To evaluate the evidence for the use of probiotics in the prevention of acute diarrhoea, we did a meta-analysis of the available data from 34 masked, randomised, placebo-controlled trials. Only one trial was community based and carried out in a developing country. Most of the remaining 33 studies were carried out in a developed country in a health-care setting. Evaluating the evidence by types of acute diarrhoea suggests that probiotics significantly reduced antibiotic-associated diarrhoea by 52% (95% CI 35-65%), reduced the risk of travellers' diarrhoea by 8% (-6 to 21%), and that of acute diarrhoea of diverse causes by 34% (8-53%). Probiotics reduced the associated risk of acute diarrhoea among children by 57% (35-71%), and by 26% (7-49%) among adults. The protective effect did not vary significantly among the probiotic strains Saccharomyces boulardii, Lactobacillus rhamnosus GG, Lactobacillus acidophilus, Lactobacillus bulgaricus, and other strains used alone or in combinations of two or more strains. Although there is some suggestion that probiotics may be efficacious in preventing acute diarrhoea, there is a lack of data from community-based trials and from developing countries evaluating the effect on acute diarrhoea unrelated to antibiotic usage. The effect on acute diarrhoea is dependent on the age of the host and genera of strain used.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. ssazawal@jhsph.edu
authors.forename: Sunil
authors.initials: S
authors.lastname: Sazawal
authors.forename: Girish
authors.initials: G
authors.lastname: Hiremath
authors.forename: Usha
authors.initials: U
authors.lastname: Dhingra
authors.forename: Pooja
authors.initials: P
authors.lastname: Malik
authors.forename: Saikat
authors.initials: S
authors.lastname: Deb
authors.forename: Robert E
authors.initials: RE
authors.lastname: Black
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003967:Diarrhea / Q000517:prevention & control*; D006801:Humans; D007778:Lactobacillus / Q000254:growth & development; D019936:Probiotics / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012440:Saccharomyces / Q000254:growth & development
chemical_list: D000900:Anti-Bacterial Agents