title: Efficacy and safety of Saccharomyces boulardii for acute diarrhea.
abstract: OBJECTIVE
  The efficacy of Saccharomyces boulardii for treatment of childhood diarrhea remains unclear. Our objective was to systematically review data on the effect of S. boulardii on acute childhood diarrhea.
  
  
  METHODS
  Our data sources included Medline, Embase, CINAHL, Scopus, and The Cochrane Library up to September 2013 without language restrictions. Randomized controlled trials and non-randomized trials that evaluated effectiveness of S. boulardii for treatment of acute diarrhea in children were included. Two reviewers independently evaluated studies for eligibility and quality and extracted the data.
  
  
  RESULTS
  In total, 1248 articles were identified, of which 22 met the inclusion criteria. Pooling data from trials showed that S. boulardii significantly reduced the duration of diarrhea (mean difference [MD], -19.7 hours; 95% confidence interval [CI], -26.05 to -13.34), stool frequency on day 2 (MD, -0.74; 95% CI, -1.38 to -0.10) and day 3 (MD, -1.24; 95% CI, -2.13 to -0.35), the risk for diarrhea on day 3 (risk ratio [RR], 0.41; 95% CI, 0.27 to 0.60) and day 4 (RR, 0.38; 95% CI, 0.24 to 0.59) after intervention compared with control. The studies included in this review were varied in the definition of diarrhea, the termination of diarrhea, inclusion and exclusion criteria, and their methodological quality.
  
  
  CONCLUSIONS
  This review and meta-analysis show that S. boulardii is safe and has clear beneficial effects in children who have acute diarrhea. However, additional studies using head-to-head comparisons are needed to define the best dosage of S. boulardii for diarrhea with different causes.
authors: Department of Pharmaceutical Biotechnology and Isfahan Pharmaceutical Research Center, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran;
authors: Sahar
authors: S
authors: Feizizadeh
authors: Nutrition and Food Security Research Center, andDepartment of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors: Amin
authors: A
authors: Salehi-Abargouei
authors: Department of Pharmaceutical Biotechnology and Isfahan Pharmaceutical Research Center, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran; v_akbari@pharm.mui.ac.ir.
authors: Vajihe
authors: V
authors: Akbari
mesh_terms: D000208:Acute Disease; D001691:Biological Therapy; D002648:Child; D003967:Diarrhea / Q000628:therapy*; D006801:Humans; D012074:Remission Induction; D012440:Saccharomyces
keywords: Saccharomyces boulardi; acute diarrhea; children; efficacy and systematic review; safety