A meta-analysis and systematic review on the effect of probiotics in acute diarrhea.
OBJECTIVE
Diarrhea the second leading cause of death in childhood is caused by a variety of organisms. Rehydration reduces the risk of death but it is not effective in shortening duration of disease. Recently, probiotics have been recommended for prevention or treatment of gastrointestinal disorders including diarrhea. Considering existing documents from different aspects, it seems that results are somehow controversial or non-conclusive. Thus, we aimed to meta-analyze clinical trials to show actual benefit of probiotics in treatment of diarrhea.


METHODS
The literature search provided 1228 articles while only 19 articles focusing on the analyses performed on children were eligible to be included in the meta-analysis with a total of 3867 patients enrolled in the study. Studies in adults' diarrhea, HIV patients, diarrhea induced by Clostridium difficile, radiation and chemotherapy were also systematically reviewed.


RESULTS
The meta-analysis showed that probiotics decrease the duration of diarrhea and fever significantly in children while their effects on the duration of hospitalization, vomiting and number of stools per day were not significant. The results of systematic review on adults' diarrhea, amoebiasis, clostridium difficile-associated diarrhea, diarrhea in HIV positive patients, radiation-induced diarrhea, and chemotherapy-induced diarrhea did not support efficacy of probiotics in acute diarrhea.


CONCLUSIONS
Probiotics may reduce duration of diarrhea and fever in children but their exact efficacy in treatment of diarrhea is not obvious yet.
Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Pooneh
P
Salari
Shekoufeh
S
Nikfar
Mohammad
M
Abdollahi
D000208:Acute Disease; D000818:Animals; D016360:Clostridioides difficile / Q000302:isolation & purification; D018849:Controlled Clinical Trials as Topic / Q000379:methods; D003967:Diarrhea / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D019936:Probiotics / Q000627:therapeutic use*; D016896:Treatment Outcome