title: Emergency Department Treatment of Children With Diarrhea Who Attend Day Care: A Randomized Multidose Trial of a Lactobacillus helveticus and Lactobacillus rhamnosus Combination Probiotic.
abstract: BACKGROUND
  Benefits associated with probiotic administration to children seeking emergency department care with diarrheal disease are unknown.
  
  
  METHODS
  In this 3-site, double-blind, placebo-controlled study, children aged 4 to 48 months with gastroenteritis were randomized to receive 5 days of placebo, low-dose (4 × 10(9) colony forming units per day), or high-dose (8 × 10(9) colony forming units per day) probiotic (Lactobacillus helveticus and Lactobacillus rhamnosus) in a 2:1:1 ratio. The primary outcome was day care absenteeism.
  
  
  RESULTS
  The proportion of children missing a day of day care was 63% (39/62) and 61% (37/61) in the placebo and probiotic arms, respectively (95%CI -14.6% to 18.9%). The proportions experiencing unscheduled health care provider visits and intravenous fluid rehydration were 24% (15/62), 7% (4/62), and 30% (18/61), 5% (3/61) in the placebo and probiotic study arms, respectively (P = .52 and P = .65). None of the results differed based on probiotic dose.
  
  
  CONCLUSIONS
  The probiotic evaluated did not reduce absenteeism. Since power was suboptimal, further evaluation is required.
authors: Alberta Children's Hospital, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada stephen.freedman@albertahealthservices.ca.
authors: Stephen B
authors: SB
authors: Freedman
authors: The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors: Philip M
authors: PM
authors: Sherman
authors: SickKids Research Institute, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors: Andrew
authors: A
authors: Willan
authors: Alberta Children's Hospital, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
authors: David
authors: D
authors: Johnson
authors: CHU Ste-Justine, Université de Montréal, Montreal, Quebec, Canada.
authors: Serge
authors: S
authors: Gouin
authors: The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors: Suzanne
authors: S
authors: Schuh
mesh_terms: D002656:Child Day Care Centers; D002675:Child, Preschool; D003967:Diarrhea / Q000628:therapy*; D004311:Double-Blind Method; D004494:Education Department, Hospital; D004632:Emergency Medical Services; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D052198:Lactobacillus helveticus; D052201:Lacticaseibacillus rhamnosus; D008297:Male; D019936:Probiotics / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: child; child day care centers; diarrhea; emergency service; probiotics; randomized controlled trial