Comparative Study for Probiotics and Symbiotics Versus Placebo in Pediatrics Acute Diarrhea: Randomized Controlled Trial

Pamela Houeiss, Antoine Farah, Peter Noun, Mode AlOjaimi, Georges AbiFares, Myriam Amm, Hala Feghali, Georges Nicolas, Gisele Nader, Marie Samarani, Peter Makhoul, Marie Claude Fadous Khalife


Background: Acute diarrhea is a major cause of morbidity and mortality in children, particularly in developing countries (the second cause of death). Probiotics and symbiotics are recent treatments for this disease, especially in the acute phase. Our objective is to compare probiotic or symbiotic treatment against placebo in acute diarrhea by following the evolution of diarrhea in terms of hours, number of bowel movements, volume of stools and their consistency. On a larger scale, we want to find a cost-effective intervention that reduces the morbidity and mortality of diarrhea.

Methods: Eighty-three children aged 6 months to 5 years, from three different regions of Mount Lebanon, were randomized to receive a probiotic, a symbiotic or a placebo once daily for 5 days. Patients were excluded from the study if they had any history of a chronic disease. The statistical analysis was carried out on SPSS v22.00

Results: Out of 120 surveys distributed to parents, 84 were completed: 43 patients received probiotics (nine received Lactobacillus, 21 received spores, and 13 patients received yeast), 24 received symbiotics and 17 were controls. Stool consistency normalized on day 4 in the probiotics and symbiotics groups (P = 0.009). Less number of days with fever (P = 0.018) were observed in the probiotic and symbiotic groups (1 day) compared to placebo (4 days). No difference in the symptoms associated with diarrhea was observed in the different groups.

Conclusions: Probiotics and symbiotics normalized stool consistency in pediatric diarrhea by day 4 and decreased the number of days with fever compared to control. Our study did not show a statistically significant difference between the different probiotics and symbiotics for the treatment of diarrhea.

Int J Clin Pediatr. 2018;7(3):21-28


Acute diarrhea; Children; Probiotics; Symbiotic

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