Efficacy of L. reuteri DSM 17938 in Treating Acute Gastroenteritis in Children
Diarrheal diseases are among the most common causes of death worldwide in children under 5 years of age. Effective and timely treatment is crucial in the case of acute gastroenteritis (AGE), which is why probiotics are attracting significant attention in the context of AGE therapy. A meta-analysis published last year in the journal Nutrients focused on the efficacy of Lactobacillus reuteri DSM 17938 in treating AGE in children from 3 months to 5 years old.
Introduction
Probiotics are an effective adjunct treatment for pediatric patients with acute gastroenteritis, reducing the duration of diarrhea and alleviating symptom intensity. However, the term probiotics refers to a heterogeneous group of microorganisms, so a general statement about their efficacy in treating AGE cannot be applied to any probiotic preparation. For instance, Lactobacillus reuteri, specifically the DSM 17938 strain, which is characterized by the loss of resistance to tetracycline and lincomycin, is considered effective. The precise mechanism of action of this probiotic strain has yet to be described, but researchers and physicians believe it has an immunomodulatory effect and interacts well with the gut microbiota.
Analyzed Studies and Objectives
The presented meta-analysis included 4 randomized studies in which 347 patients were administered L. reuteri DSM 17938 in various doses and forms. Patients in the control groups either took a placebo (2 studies) or received no probiotic treatment (2 studies).
The primary objective was to compare the duration of diarrhea and stool volume. Secondary objectives included comparing the course of acute gastroenteritis, assessing how many cases of AGE had diarrhea lasting more than 7 days, or evaluating the length of hospitalization.
Daily doses of L. reuteri DSM 17938 ranged from 1 × 108 CFU (for 5 days) to 4 × 108 CFU (for 7 days). In all studies, the probiotic was administered as an adjunct treatment to oral or intravenous rehydration therapy.
Results
The meta-analysis results indicate that the average duration of diarrhea in children treated with L. reuteri DSM 17938 was 0.87 days shorter than those given a placebo. Hospitalization was also shorter for the probiotic groups (-0.54 days; 95% Confidence Interval [CI] -1.09 to 0.0; high heterogeneity). Administration of L. reuteri DSM 17938 showed improvement in the condition on the 1st and 2nd days of illness compared to the placebo, with no differences observed between groups in later days. None of the studies examined stool volume, so this parameter could not be evaluated. The overall quality of evidence according to the GRADE system was rated as low to very low for all 4 analyzed studies.
Summary and Conclusion
The meta-analysis confirms previous findings regarding the use of L. reuteri DSM 17938 in treating acute gastroenteritis. Adding this probiotic to standard rehydration therapy shortens the duration of diarrhea by several hours and also shortens hospitalization. Its use further increases the likelihood of symptom relief within the first 2 days of illness. Although the meta-analysis has some limitations, such as the small number of evaluated studies, it contributes to a better understanding of AGE treatment options and confirms existing knowledge that L. reuteri DSM 17938 has a positive effect in treating AGE in children.
(pak)
Source: Patro-Gołąb B., Szajewska H. Systematic review with meta-analysis: Lactobacillus reuteri DSM 17938 for treating acute gastroenteritis in children. An update. Nutrients 2019 Nov 14; 11 (11), pii: E2762, doi: 10.3390/nu11112762.
Did you like this article? Would you like to comment on it? Write to us. We are interested in your opinion. We will not publish it, but we will gladly answer you.
