title: Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatient setting.
abstract: OBJECTIVE
  Two randomized controlled clinical trials have shown that Lactobacillus (L) reuteri DSM 17938 reduces the duration of diarrhea in children hospitalized due to acute infectious diarrhea. This was the first trial evaluating the efficacy of L. reuteri DSM 17938 in outpatient children with acute infectious diarrhea.
  
  
  METHODS
  This was a multicenter, randomized, single-blinded, case control clinical trial in children with acute watery diarrhea. A total of 64 children who presented at outpatient clinics were enrolled. The probiotic group received 1×10(8)CFU L. reuteri DSM 17938 for five days in addition to oral rehydration solution (ORS) and the second group was treated with ORS only. The primary endpoint was the duration of diarrhea (in hours). The secondary endpoint was the number of children with diarrhea at each day of the five days of intervention. Adverse events were also recorded.
  
  
  RESULTS
  The mean duration of diarrhea was significantly reduced in the L. reuteri group compared to the control group (approximately 15h, 60.4±24.5h [95% CI: 51.0-69.7h] vs. 74.3±15.3h [95% CI: 68.7-79.9h], p<0.05). The percentage of children with diarrhea was lower in the L. reuteri group (13/29; 44.8%) after 48h than the control group (27/31; 87%; RR: 0.51; 95% CI: 0.34-0.79, p<0.01). From the 72nd hour of intervention onwards, there was no difference between the two groups in the percentage of children with diarrhea. No adverse effects related to L. reuteri were noted.
  
  
  CONCLUSIONS
  L. reuteri DSM 17938 is effective, safe, and well-tolerated in outpatient children with acute infectious diarrhea.
authors.affiliation: Faculty of Medicine, Department of Pediatrics, Pediatric Intensive Care and Infectious Disease Unit, Eskisehir Osmangazi University, Eskisehir, Turkey. Electronic address: timboothtr@yahoo.com.
authors.forename: Ener Cagri
authors.initials: EC
authors.lastname: Dinleyici
authors.affiliation: Division of Pediatric Infectious Diseases, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Nazan
authors.initials: N
authors.lastname: Dalgic
authors.affiliation: Department of Pediatrics, Umraniye Education & Research Hospital, Istanbul, Turkey.
authors.forename: Sirin
authors.initials: S
authors.lastname: Guven
authors.affiliation: Pediatric Infectious Disease Unit, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Metin
authors.affiliation: Department of Pediatrics, Goztepe Training and Research Hospital, SB Istanbul Medeniyet University, Istanbul, Turkey.
authors.forename: Olcay
authors.initials: O
authors.lastname: Yasa
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Ege University, İzmir, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Kurugol
authors.affiliation: Department of Pediatric Infectious Disease Unit, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Ozden
authors.initials: O
authors.lastname: Turel
authors.affiliation: Pediatric Infectious Disease Unit, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey.
authors.forename: Gonul
authors.initials: G
authors.lastname: Tanir
authors.affiliation: Department of Pediatrics, Umraniye Education & Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet Sami
authors.initials: AS
authors.lastname: Yazar
authors.affiliation: Department of Pediatrics, Okmeydani Education and Research Hospital, Istanbul, Turkey.
authors.forename: Vefik
authors.initials: V
authors.lastname: Arica
authors.affiliation: Faculty of Pharmacy, Clinical Pharmacy Department, Marmara University, Istanbul, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Sancar
authors.affiliation: Department of Pediatrics, Okmeydani Education and Research Hospital, Istanbul, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Karbuz
authors.affiliation: Faculty of Medicine, Pediatric Infectious Disease Unit, Hacettepe University, Ankara, Turkey.
authors.forename: Makbule
authors.initials: M
authors.lastname: Eren
authors.affiliation: Department of Pediatrics, Okmeydani Education and Research Hospital, Istanbul, Turkey.
authors.forename: Metehan
authors.initials: M
authors.lastname: Ozen
authors.affiliation: Faculty of Pharmacy, Clinical Pharmacy Department, Marmara University, Istanbul, Turkey.
authors.forename: Ates
authors.initials: A
authors.lastname: Kara
authors.affiliation: Department of Pediatrics, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D003967:Diarrhea / Q000628:therapy*; D003968:Diarrhea, Infantile / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D052200:Limosilactobacillus reuteri; D008297:Male; D010045:Outpatients / Q000706:statistics & numerical data; D019936:Probiotics / Q000627:therapeutic use*; D016037:Single-Blind Method; D013997:Time Factors
keywords: Ambulatory care; Children; Crianças; Cuidado ambulatorial; Diarreia; Diarrhea; Lactobacillus reuteri DSM 17938; Probiotic; Probióticos