title: The effect of Lactobacillus GG on acute diarrheal illness in the pediatric emergency department.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effectiveness of the probiotic Lactobacillus GG (LGG) in reducing the duration of acute infectious diarrhea in the pediatric emergency department.
  
  
  METHODS
  We conducted a double-blind, randomized controlled trial of children 6 months to 6 years presenting to the pediatric emergency department with a complaint of diarrhea. Patients were randomized to receive either placebo or LGG powder twice daily for 5 days. With each dose, parents recorded the stool history in a home diary and were followed up daily by a blinded researcher. Groups were compared in terms of time to normal stool and number of diarrheal stools.
  
  
  RESULTS
  Of 155 patients enrolled, 129 completed the study: 63 in the LGG group and 66 in the placebo group. There was no significant difference in the median (interquartile range) time to normal stool (LGG: 60 hours [37-111] vs placebo: 74 hours [43-120]; P = 0.37) or the number of diarrheal stools (LGG: 5.0 [1-10] vs placebo: 6.5 [2-14]; P = 0.19). Among children who presented with more than 2 days of diarrhea, the LGG group returned to normal stool earlier (LGG: 51 hours [32-78] vs placebo: 74 hours [45-120]; P = 0.02), had fewer episodes of diarrheal stools (LGG: 3.5 [1.0-7.5] vs placebo: 7 [3.0-16.3]; P = 0.02), and were 2.2 times more likely to return to normal stool (95% confidence interval, 1.3-3.9; P = 0.01) compared with children in the placebo group.
  
  
  CONCLUSIONS
  Lactobacillus GG may reduce the duration of acute diarrheal illness among children presenting with more than 2 days of symptoms.
authors.affiliation: Department of Pediatrics, Jacobi Medical Center, Bronx, NY 10461, USA. abby.nixon@gmail.com
authors.forename: Abigail F
authors.initials: AF
authors.lastname: Nixon
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Cunningham
authors.forename: Hillel W
authors.initials: HW
authors.lastname: Cohen
authors.forename: Ellen F
authors.initials: EF
authors.lastname: Crain
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D003967:Diarrhea / Q000628:therapy*; D004311:Double-Blind Method; D004630:Emergencies; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007778:Lactobacillus; D008297:Male; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome