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Aliment Pharmacol Ther. 2019 Jun;49(11):1376-1384. doi: 10.1111/apt.15267. Epub 2019 Apr 25.

Systematic review with meta-analysis: Lactobacillus rhamnosus GG for treating acute gastroenteritis in children - a 2019 update.

Author information

1
Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.
2
Sackler Faculty of Medicine, Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Tel-Aviv University, Tel-Aviv, Israel.

Abstract

BACKGROUND:

Recently, evidence from a large randomised controlled trial (RCT) negated efficacy of Lactobacillus rhamnosus GG for treating acute gastroenteritis in children.

AIM:

To review RCTs in which L rhamnosus GG was used to treat acute gastroenteritis in children.

METHODS:

The Cochrane Library, MEDLINE, and EMBASE databases were searched from May 2013 (end of last search) to January 2019. The primary outcomes were stool volume and duration of diarrhoea.

RESULTS:

Eighteen RCTs (n = 4208) were included. Compared with placebo or no treatment, L rhamnosus GG use had no effect on stool volume but was associated with a reduced duration of diarrhoea (15 RCTs, n = 3820, mean difference, MD -0.85 day, 95% CI -1.15 to -0.56). L rhamnosus GG was effective when used at a daily dose of ≥1010 CFU or <1010 CFU; however, the latter produced results of borderline significance. L rhamnosus GG was more effective when used in European countries compared with non-European countries, particularly when considered by region. L rhamnosus GG use was associated with a reduced duration of hospitalisation. One RCT found that L rhamnosus GG had no effect on the total clinical severity score at 14 days after enrolment.

CONCLUSIONS:

Despite a recent large RCT demonstrating no effect of L rhamnosus GG, current evidence shows that, overall, L rhamnosus GG reduced both the duration of diarrhoea (with a higher impact in European countries) and hospitalisation in inpatients. These findings should be viewed in the context of the high heterogeneity and methodological limitations of the included trials.

PMID:
31025399
DOI:
10.1111/apt.15267

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