title: Double-blind, randomized evaluation of clinical efficacy and tolerability of an apple pectin-chamomile extract in children with unspecific diarrhea.
abstract: BACKGROUND
  Acute diarrhea is one of the most common childhood diseases. The main aim of therapy is oral rehydration, mostly using a glucose-electrolyte solution. Results from a previous study (DIALOG I) investigating adjuvant treatment with a medicinal preparation containing an apple pectin-chamomile extract (Diarrhoesan) indicated a significantly reduced duration of diarrhea in children.
  
  
  OBJECTIVE
  The objective of the present clinical placebo-controlled, double-blind study (DIALOG II) was to assess the clinical efficacy and tolerability of the apple pectin-chamomile extract on a larger number of patients.
  
  
  METHODS
  The investigation was designed as a multicenter, randomized, double-blind, placebo-controlled parallel study enrolling 255 patients presenting with acute diarrhea. Patients were aged between 6 months and 6 years and treated on an outpatient basis with either an apple pectin-chamomile preparation or placebo. As a basic medication, each child received a glucose-electrolyte solution on the first day of treatment.
  
  
  RESULTS
  The primary outcome (primary efficacy parameter) included a combined analysis of stool frequency, stool The statistical analysis revealed a superior efficacy of the tested preparation over placebo with a significantly reduced stool frequency in the treatment group compared to the control group. The results were corroborated by efficacy assessment performed by investigators and patients. Treatment was well tolerated, with an incidence of adverse effects similar to placebo.
  
  
  CONCLUSIONS
  These findings support the concept of a beneficial influence of the investigated vegetable extract in shortening the course of the disease and relieving associated symptoms.
authors.affiliation: Medical Office for Pediatrics and Allergology, Bonn, Germany.
authors.forename: Brigitta
authors.initials: B
authors.lastname: Becker
authors.forename: Ulrike
authors.initials: U
authors.lastname: Kuhn
authors.forename: Bettina
authors.initials: B
authors.lastname: Hardewig-Budny
mesh_terms: D000930:Antidiarrheals / Q000009:adverse effects / Q000627:therapeutic use*; D020843:Chamomile; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000188:drug therapy* / Q000382:microbiology; D004311:Double-Blind Method; D005243:Feces / Q000382:microbiology; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007223:Infant; D008297:Male; D027845:Malus / Q000737:chemistry*; D010368:Pectins / Q000009:adverse effects / Q000627:therapeutic use*; D010936:Plant Extracts / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000930:Antidiarrheals; D010936:Plant Extracts; D010368:Pectins