title: Saccharomyces boulardii in acute childhood diarrhoea: a randomized, placebo-controlled study.
abstract: OBJECTIVE
  To evaluate the efficacy of the probiotic yeast Saccharomyces boulardii (S. boulardii) as an adjuvant to oral rehydration solution (ORS) in shortening the duration of acute infectious gastroenteritis in children less than 2 years old in ambulatory care.
  
  
  METHODS
  In a period of 1 year, 100 outpatients between 3 and 24 months old presenting with acute mild to moderate diarrhoea of less than 7 days duration, were included in a double-blind, randomized, placebo-controlled trial evaluating the efficacy of S. boulardii administered for 6 days. Twelve children were lost in follow-up; the data of 88 children could be analysed (44 in the placebo and 44 in the S. boulardii group). Seventy-two patients were followed for one month (37 in the placebo and 35 in the S. boulardii group) allowing the calculation of the duration of diarrhoea.
  
  
  RESULTS
  The mean duration of diarrhoea was 6.16 days (range 2-13 days) in the placebo group and 4.70 days (range 2-10 days) in the S. boulardii group (p<0.05). On the 4th day, the patients in the S. boulardii group passed 2.5+/-1.4 stools/day versus 3.5+/-1.8 in the placebo group (p<0.001). The risk of having diarrhoea lasting more than 7 days was lower in the S. boulardii group (3/44 versus 12/44; RR 0.25; 95% CI 0.1-0.8). In no patient diarrhoea persisted longer than 14 days. A statistically significant difference was observed in the number of stools on the 4th and 7th day favouring the subgroup that received early treatment (within the first 48 h of the onset of diarrhoea). The administration of antibiotics before inclusion did not make any difference.
  
  
  CONCLUSIONS
  S. boulardii as an adjuvant to ORS in ambulatory care in children less than 2 years old with mild or moderate acute diarrhoea decreased the duration of diarrhoea, accelerated recovery and reduced the risk of prolonged diarrhoea. The data also indicate increased efficacy if S. boulardii is administered within the first 48 h of the onset of diarrhoea.
authors.affiliation: Hospital Privado Materno Infantil, National University of Salta, Campo Castañares, Salta, Argentina.
authors.forename: Gladys
authors.initials: G
authors.lastname: Villarruel
authors.forename: Daniel Martinez
authors.initials: DM
authors.lastname: Rubio
authors.forename: Fani
authors.initials: F
authors.lastname: Lopez
authors.forename: Julio
authors.initials: J
authors.lastname: Cintioni
authors.forename: Rubén
authors.initials: R
authors.lastname: Gurevech
authors.forename: Gladis
authors.initials: G
authors.lastname: Romero
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
mesh_terms: D003131:Combined Modality Therapy; D004311:Double-Blind Method; D004403:Dysentery / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019936:Probiotics / Q000008:administration & dosage / Q000627:therapeutic use*; D012440:Saccharomyces; D013997:Time Factors; D016896:Treatment Outcome