title: The effectiveness of probiotics for managing diarrhoea in people with HIV infection: a critically appraised topic.
abstract: OBJECTIVE
  The implications of HIV infection are vast. Management of clinical symptomatology, though, cannot be overshadowed by focus on disease management. These must be managed in concert. Diarrhoea, a common complaint of HIV-infected people, can be difficult to manage, and complicated further by polypharmacy. This review will critically appraise literature related to the management of diarrhoea with probiotics in HIV-infected people.
  
  
  METHODS
  PubMed, CINAHL, and The Cochrane Library were searched for randomized controlled trials investigating the use of probiotics in HIV-infected people, which included diarrhoeal symptoms as a primary or secondary endpoint.
  
  
  RESULTS
  Three randomized controlled trials and one randomized control cross-over study were identified as best evidence. One study identified a statistically significant improvement in diarrhoea for those treated with probiotics. An additional study identified improvement in diarrhoea; however, a similar improvement was seen in those treated with placebo. Two studies did not identify a statistical difference for those treated with probiotics.
  
  
  CONCLUSIONS
  There is insufficient evidence to allow a strong recommendation to be made for or against the use of probiotics for diarrhoea, but safety and lack of drug-drug interactions make it a reasonable option for some patients.
authors.affiliation: Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA. seangu@pcom.edu
authors.forename: S
authors.initials: S
authors.lastname: Guinane
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003967:Diarrhea / Q000178:diet therapy* / Q000821:virology; D019317:Evidence-Based Medicine; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic