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.
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.
Authors: Stephen B Freedman; Yaron Finkelstein; Xiao Li Pang; Linda Chui; Phillip I Tarr; John M VanBuren; Cody Olsen; Bonita E Lee; Carla A Hall-Moore; Robert Sapien; Karen O'Connell; Adam C Levine; Naveen Poonai; Cindy Roskind; Suzanne Schuh; Alexander Rogers; Seema Bhatt; Serge Gouin; Prashant Mahajan; Cheryl Vance; Katrina Hurley; Elizabeth C Powell; Ken J Farion; David Schnadower Journal: Clin Infect Dis Date: 2022-08-24 Impact factor: 20.999
Authors: Mary Ellen Sanders; Daniel J Merenstein; Gregor Reid; Glenn R Gibson; Robert A Rastall Journal: Nat Rev Gastroenterol Hepatol Date: 2019-07-11 Impact factor: 46.802
Authors: Shelui Collinson; Andrew Deans; April Padua-Zamora; Germana V Gregorio; Chao Li; Leonila F Dans; Stephen J Allen Journal: Cochrane Database Syst Rev Date: 2020-12-08
Authors: David Schnadower; Karen J O'Connell; John M VanBuren; Cheryl Vance; Phillip I Tarr; Suzanne Schuh; Katrina Hurley; Alexander J Rogers; Naveen Poonai; Cindy G Roskind; Seema R Bhatt; Serge Gouin; Prashant Mahajan; Cody S Olsen; Elizabeth C Powell; Ken Farion; Robert E Sapien; Thomas H Chun; Stephen B Freedman Journal: Am J Gastroenterol Date: 2021-07-01 Impact factor: 12.045