The significance of probiotics as an adjuvant therapy by acute gastroenteritis in children under 5 years old

Abstract

Acute gastroenteritis (AGE) is one of the most common diseases worldwide. Most cases are self-limited and do not required medication. However, in the world there are various recommendations about the use of probiotics in addition to oral rehydration solutions in treatment of AGE.
Aim. To substantiate the choice of probiotics as adjuvant therapy for AGE, including rotavirus etiology, in children under 5 years by comparing the significance of probiotics with different types of evidence.
Materials and methods. 265 children under 5 who were hospitalized at infectious department with symptoms of AGE were monitored from 2015 to 2017. The choice of probiotic drug was accidental and depended on the availability of a type of probiotics at the time of hospitalization. The following clinical criteria were evaluated: number of episodes of rare faeces per day, duration of hospitalization, and duration of diarrheal syndrome. Non-parametric statistical criteria were used for the calculation.
Results. There are a significant difference in the episodes of stool per day by rotavirus AGE. Lactobacillus rhamnosus GG (LGG) or Saccharomyces boulardii (S. boulardii) have shown the better effect in reduction of stool frequency then L reuteri DSM 17938 (p<0.05). We received the same affect when compared LGG / S. boulardii with probiotics with insufficient evidence (European Society for Paediatric Gastroenterology, Hepatology and Nutrition, 2014). There are no significant differences between the probiotics in the duration of hospitalization and the duration of diarrheal syndrome.
Conclusions. Probiotics reduce the stool frequency, but they have any effect on the duration of diarrhea syndrome and duration of hospitalization. Probiotics which have insufficient evidence have shown the best results in rotavirus AGE. Among probiotics, which lack evidence base, the least effect was a multiprobiotic with the following composition: Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophylus, Bifidobacterium breve, Lactobacillus acidophylus, Bifidobacterium infantis, Lactobacillus bulgaricus.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee (LEC) of an participating institution. The informed consent of the patient was obtained for conducting the studies.