title: [Efficacy of racecadotril vs. smectite, probiotics or zinc as an integral part of treatment of acute diarrhea in children under five years: A meta-analysis of multiple treatments].
abstract: BACKGROUND
  Despite major advances in treatment, acute diarrhea continues to be a public health problem in children under five years. There is no systematic approach to treatment and most evidence is assembled comparing active treatment vs. placebo.
  
  
  OBJECTIVE
  Systematic review of evidence on efficacy of adjuvants for treatment of acute diarrhea through a network meta-analysis.
  
  
  METHODS
  A systematic search of multiple databases searching clinical trials related to the use of racecadotril, smectite, Lactobacillus GG, Lactobacillus reuteri, Saccharomyces boulardii and zinc as adjuvants in acute diarrhea was done. The primary endpoint was duration of diarrhea. Information is displayed through network meta-analysis.The superiority of each coadjutant was analyzed by Sucra approach.
  
  
  RESULTS
  Network meta-analysis showed race cadotril was better when compared with placebo and other adjuvants. Sucra analysis showed racecadotril as the first option followed by smectite and Lactobacillus reuteri.
  
  
  CONCLUSIONS
  Considering a strategic decision making approach, network meta-analysis allows us to establish the therapeutic superiority of racecadotril as an adjunct for the comprehensive management of acute diarrhea in children aged less than five years.
authors.affiliation: Unidad de Investigación Translacional en Salud, Hospital General Dr. Manuel Gea González, México, D.F., México.
authors.forename: Pedro
authors.initials: P
authors.lastname: Gutiérrez-Castrellón
authors.affiliation: Departamento de Urgencias, Instituto Nacional de Pediatría, México, D.F., México.
authors.forename: Anna Alejandra
authors.initials: AA
authors.lastname: Ortíz-Hernández
authors.affiliation: Departamento de Urgencias, Instituto Nacional de Pediatría, México, D.F., México.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Llamosas-Gallardo
authors.affiliation: Departamento de Urgencias, Instituto Nacional de Pediatría, México, D.F., México.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Acosta-Bastidas
authors.affiliation: Unidad de Análisis de la Evidencia y Grupo Cochrane, Hospital General Dr. Manuel Gea González, México, D.F., México.
authors.forename: Carlos
authors.initials: C
authors.lastname: Jiménez-Gutiérrez
authors.affiliation: Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, México, D.F., México.
authors.forename: Luisa
authors.initials: L
authors.lastname: Diaz-García
authors.affiliation: Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, México, D.F., México.
authors.forename: Anahí
authors.initials: A
authors.lastname: Anzo-Osorio
authors.affiliation: Departamento de Urgencias, Instituto Nacional de Pediatría, México, D.F., México.
authors.forename: Juliana
authors.initials: J
authors.lastname: Estevez-Jiménez
authors.affiliation: Dirección Médica, Hospital General Dr. Manuel Gea González, México, D.F., México.
authors.forename: Irma
authors.initials: I
authors.lastname: Jiménez-Escobar
authors.affiliation: Departamento de Proyectos Estratégicos, Hospital General Dr. Manuel Gea González, México, D.F., México.
authors.forename: Rosa Patricia
authors.initials: RP
authors.lastname: Vidal-Vázquez
mesh_terms: D000208:Acute Disease; D000930:Antidiarrheals / Q000627:therapeutic use*; D002675:Child, Preschool; D003967:Diarrhea / Q000188:drug therapy*; D006801:Humans; D019936:Probiotics / Q000627:therapeutic use; D017640:Silicates / Q000627:therapeutic use; D015244:Thiorphan / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015032:Zinc / Q000627:therapeutic use
chemical_list: D000930:Antidiarrheals; D017640:Silicates; C049331:racecadotril; C033214:Smectite; D015244:Thiorphan; D015032:Zinc