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Probiotic May Not Be Effective for Acute Gastroenteritis in Children

While probiotics often are used to treat acute gastroenteritis (also known as infectious diarrhea) in children, the latest evidence shows no significant differences in outcomes compared with placebo. These results come from a large, double-blinded, randomized controlled trial conducted at 10 geographically diverse US pediatric emergency departments (EDs), including Kenneth & Anne Griffin Emergency Care Center at Ann & Robert H. Lurie Children’s Hospital of Chicago. Findings were published in the New England Journal of Medicine.

“This study presents the most robust evidence to date that use of probiotics doesn’t improve outcomes of acute gastroenteritis in children, which calls into question current recommendations,” says author Elizabeth Powell, MD, MPH, a pediatric emergency medicine specialist at Lurie Children’s and a professor of pediatrics at Northwestern University Feinberg School of Medicine. “Recommendations to use probiotics for these patients were based on previous meta-analyses that have suggested probiotics may be beneficial, but the trials that were included had significant limitations. The rigor of our research design and our results warrant reconsideration of common practice.”

Acute gastroenteritis, which can present with diarrhea, vomiting, and abdominal pain, accounts for approximately 1.7 million visits to the ED and more than 70,000 hospitalizations per year in the United States. It’s the second-leading cause of death worldwide in children younger than age 5.

The study included 943 children, aged 3 months to 4 years. Two weeks after an ED visit for acute gastroenteritis, children in the study who received a five-day course of a probiotic (Lactobacillus rhamnosus) fared no better than the placebo group in terms of illness severity, duration and frequency of diarrhea or vomiting, day-care absenteeism, and rate of household transmission of the infection.