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Efficacy of Lactobacillus rhamnosus GG in treatment of acute pediatric diarrhea : A systematic review with meta-analysis

Li, Ya Ting ; Xu, Hong ; Ye, Jian Zhong ; Wu, Wen Rui ; Shi, Ding ; Fang, Dai Qiong ; Liu, Yang LU and Li, Lan Juan (2019) In World Journal of Gastroenterology 25(33). p.4999-5016
Abstract

BACKGROUND Diarrhea is a major infectious cause of childhood morbidity and mortality worldwide. In clinical trials, Lactobacillus rhamnosus GG ATCC 53013 (LGG) has been used to treat diarrhea. However, recent randomized controlled trials (RCTs) found no evidence of a beneficial effect of LGG treatment. AIM To evaluate the efficacy of LGG in treating acute diarrhea in children. METHODS The EMBASE, MEDLINE, PubMed, Web of Science databases, and the Cochrane Central Register of Controlled Trials were searched up to April 2019 for metaanalyses and RCTs. The Cochrane Review Manager was used to analyze the relevant data. RESULTS Nineteen RCTs met the inclusion criteria and showed that compared with the control group, LGG administration... (More)

BACKGROUND Diarrhea is a major infectious cause of childhood morbidity and mortality worldwide. In clinical trials, Lactobacillus rhamnosus GG ATCC 53013 (LGG) has been used to treat diarrhea. However, recent randomized controlled trials (RCTs) found no evidence of a beneficial effect of LGG treatment. AIM To evaluate the efficacy of LGG in treating acute diarrhea in children. METHODS The EMBASE, MEDLINE, PubMed, Web of Science databases, and the Cochrane Central Register of Controlled Trials were searched up to April 2019 for metaanalyses and RCTs. The Cochrane Review Manager was used to analyze the relevant data. RESULTS Nineteen RCTs met the inclusion criteria and showed that compared with the control group, LGG administration notably reduced the diarrhea duration [mean difference (MD) -24.02 h, 95% confidence interval (CI) (-36.58, -11.45)]. More effective results were detected at a high dose . 1010 CFU per day [MD -22.56 h, 95%CI (-36.41, -8.72)] vs a lower dose. A similar reduction was found in Asian and European patients [MD -24.42 h, 95%CI (-47.01, -1.82); MD -32.02 h, 95%CI (- 49.26, -14.79), respectively]. A reduced duration of diarrhea was confirmed in LGG participants with diarrhea for less than 3 d at enrollment [MD -15.83 h, 95%CI (-20.68, -10.98)]. High-dose LGG effectively reduced the duration of rotavirus-induced diarrhea [MD -31.05 h, 95%CI (-50.31, -11.80)] and the stool number per day [MD -1.08, 95%CI (-1.87, -0.28)]. CONCLUSION High-dose LGG therapy reduces the duration of diarrhea and the stool number per day. Intervention at the early stage is recommended. Future trials are expected to verify the effectiveness of LGG treatment.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute diarrhea, Children, Lactobacillus rhamnosus GG, Meta-analysis, Probiotics, Rotavirus, Systematic review
in
World Journal of Gastroenterology
volume
25
issue
33
pages
18 pages
publisher
WJG Press
external identifiers
  • pmid:31543689
  • scopus:85072321855
ISSN
1007-9327
DOI
10.3748/wjg.v25.i33.4999
language
English
LU publication?
yes
id
bb1a4c56-79ac-4008-b0f2-7a7b802989bd
date added to LUP
2019-10-01 12:04:17
date last changed
2024-03-04 01:29:13
@article{bb1a4c56-79ac-4008-b0f2-7a7b802989bd,
  abstract     = {{<p>BACKGROUND Diarrhea is a major infectious cause of childhood morbidity and mortality worldwide. In clinical trials, Lactobacillus rhamnosus GG ATCC 53013 (LGG) has been used to treat diarrhea. However, recent randomized controlled trials (RCTs) found no evidence of a beneficial effect of LGG treatment. AIM To evaluate the efficacy of LGG in treating acute diarrhea in children. METHODS The EMBASE, MEDLINE, PubMed, Web of Science databases, and the Cochrane Central Register of Controlled Trials were searched up to April 2019 for metaanalyses and RCTs. The Cochrane Review Manager was used to analyze the relevant data. RESULTS Nineteen RCTs met the inclusion criteria and showed that compared with the control group, LGG administration notably reduced the diarrhea duration [mean difference (MD) -24.02 h, 95% confidence interval (CI) (-36.58, -11.45)]. More effective results were detected at a high dose . 1010 CFU per day [MD -22.56 h, 95%CI (-36.41, -8.72)] vs a lower dose. A similar reduction was found in Asian and European patients [MD -24.42 h, 95%CI (-47.01, -1.82); MD -32.02 h, 95%CI (- 49.26, -14.79), respectively]. A reduced duration of diarrhea was confirmed in LGG participants with diarrhea for less than 3 d at enrollment [MD -15.83 h, 95%CI (-20.68, -10.98)]. High-dose LGG effectively reduced the duration of rotavirus-induced diarrhea [MD -31.05 h, 95%CI (-50.31, -11.80)] and the stool number per day [MD -1.08, 95%CI (-1.87, -0.28)]. CONCLUSION High-dose LGG therapy reduces the duration of diarrhea and the stool number per day. Intervention at the early stage is recommended. Future trials are expected to verify the effectiveness of LGG treatment.</p>}},
  author       = {{Li, Ya Ting and Xu, Hong and Ye, Jian Zhong and Wu, Wen Rui and Shi, Ding and Fang, Dai Qiong and Liu, Yang and Li, Lan Juan}},
  issn         = {{1007-9327}},
  keywords     = {{Acute diarrhea; Children; Lactobacillus rhamnosus GG; Meta-analysis; Probiotics; Rotavirus; Systematic review}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{33}},
  pages        = {{4999--5016}},
  publisher    = {{WJG Press}},
  series       = {{World Journal of Gastroenterology}},
  title        = {{Efficacy of Lactobacillus rhamnosus GG in treatment of acute pediatric diarrhea : A systematic review with meta-analysis}},
  url          = {{http://dx.doi.org/10.3748/wjg.v25.i33.4999}},
  doi          = {{10.3748/wjg.v25.i33.4999}},
  volume       = {{25}},
  year         = {{2019}},
}