title: Meta-analysis: Lactobacillus GG for treating acute gastroenteritis in children--updated analysis of randomised controlled trials.
abstract: BACKGROUND
  The efficacy of each probiotic should be evaluated separately. Previously, we have shown that Lactobacillus GG (LGG) is effective in treating acute gastroenteritis (AGE) in children.
  
  
  OBJECTIVE
  To update our 2007 meta-analysis on the effectiveness of LGG in treating AGE in children.
  
  
  METHODS
  The Cochrane Library, MEDLINE and EMBASE databases were searched from August 2006 (end date of last search) to May 2013, with no language restrictions, for randomised controlled trials (RCTs) and meta-analyses.
  
  
  RESULTS
  Fifteen RCTs (2963 participants) met the inclusion criteria in this updated meta-analysis. Combined data from 11 RCTs (n = 2444) showed that LGG significantly reduced the duration of diarrhoea compared with placebo or no treatment (mean difference, MD -1.05 days, 95% CI -1.7 to -0.4). LGG was more effective when used at a daily dose ≥10¹⁰ CFU (eight RCTs, n = 1488, MD -1.11 days, 95% CI -1.91 to -0.31) than when used at a daily dose <10¹⁰ CFU (three RCTs, n = 956, MD -0.9 day, 95% CI -2.5 to 0.69). LGG was effective in children treated in Europe (five RCTs, n = 744, MD -1.27 days, 95% CI -2.04 to -0.49); in the non-European setting, the difference between the LGG group and the control group was of a borderline statistical significance (six RCTs, n = 1700, MD -0.87, 95% CI -1.81 to 0.08).
  
  
  CONCLUSIONS
  Lactobacillus GG reduces the duration of diarrhoea. A subset of patients that is more likely to benefit includes subjects treated with a high daily dose of LGG (≥10¹⁰ CFU/day) who are either in-patients or out-patients from geographical Europe. Given the methodological limitations of many of the included trials, the evidence should be viewed with caution.
authors.affiliation: Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland. hania@ipgate.pl
authors.forename: H
authors.initials: H
authors.lastname: Szajewska
authors.forename: A
authors.initials: A
authors.lastname: Skórka
authors.forename: M
authors.initials: M
authors.lastname: Ruszczyński
authors.forename: D
authors.initials: D
authors.lastname: Gieruszczak-Białek
mesh_terms: D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000517:prevention & control; D005759:Gastroenteritis / Q000628:therapy*; D006801:Humans; D052201:Lacticaseibacillus rhamnosus; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome