Effects of Probiotics and/or Prebiotics on the Duration of Diarrhea and Hospitalization in Children
Effects of Probiotics and/or Prebiotics on the Duration of Diarrhea and Hospitalization in Children
-  Acute diarrhea continues to be a major cause of childhood morbidity and mortality in
 developed and developing countries.

 -  Prevention and treatment of dehydration are the mainstays of therapy. Rehydration can be
 achieved with oral rehydratation solution (ORS).

 -  Even though ORS has reduced the mortality and morbidity very significantly, it has no
 effect on the duration of diarrhea, stool consistency and frequency and remains
 underused.

 -  ESPGHAN and ESPID published together an evidence based guideline and stated that in the
 management of acute gastroenteritis rehydration is the key treatment and that selected
 probiotics may reduce the duration and intensity of symptoms and can be used as an
 adjuvant to ORS.

 -  Current evidence also indicates that probiotic effects are strain-specific.
 Lactobacillus GG and Saccharomyces boulardii are the best studied strains. However, more
 research is needed to guide the use of particular probiotic regimens and strains and as
 there is still no evidence of efficacy for many preparations.
Acute diarrhea continues to be a major cause of childhood morbidity and mortality in
 developed and developing countries. Prevention and treatment of dehydration are the mainstays
 of therapy. Rehydration can be achieved with oral rehydratation solution (ORS). Even though
 ORS has reduced the mortality and morbidity very significantly, it has no effect on the
 duration of diarrhea, stool consistency and frequency and remains underused. ESPGHAN and
 ESPID published together an evidence based guideline and stated that in the management of
 acute gastroenteritis rehydration is the key treatment and that selected probiotics may
 reduce the duration and intensity of symptoms and can be used as an adjuvant to ORS. A recent
 Cochrane review including 56 trials in children concluded that speciﬁc probiotics reduce the
 duration of diarrhea with about 24 hours and decrease the frequency of defecation on the
 second day. Current evidence also indicates that probiotic effects are strain-specific.
 Lactobacillus LGG and Saccharomyces boulardii are the best studied strains. However, more
 research is needed to guide the use of particular probiotic regimens and strains and as there
 is still no evidence of efficacy for many preparations. The aim of this study was to evaluate
 effects of different probiotics on the duration of acute infectious diarrhea.
Inclusion Criteria:

 -  children of both sexes aged between 3 and 60 months, with acute watery diarrhea
 lasting more than 12 hours but less than 72 hours, requiring hospitalization. Children
 with clinical signs of mild to moderate dehydration (prolonged capillary refill time,
 abnormal skin turgor and 3-9% percentage loss of body weight).

 Exclusion Criteria:

 -  clinical features of hypovolemic shock and/or necessitating admission at the intensive
 care unit were excluded. Other exclusion criteria were use of antibiotics or
 probiotics 1 month before admission, severe malnutrition and chronic underlying
 disease including immunocompromised conditions