Treating Acute Gastroenteritis

Treating Acute Gastroenteritis


Every year, gastroenteritis accounts for
1.7 million visits to emergency departments by children in the United
States. Probiotics represent an expanding industry with potential clinical
benefits, but there are limited data supporting their use in this population. This multicenter, randomized double-blind trial included 886 children between 3
and 48 months old who presented to the emergency department with acute
intestinal infection clinically diagnosed on the basis of three or more
episodes of watery stools in a 24-hour period and vomiting or diarrhea for less
than 72 hours. The children were randomized to take by mouth once a sachet
of probiotic preparation containing lactobacillus rhamnosus and
lactobacillus helvetica’s or placebo twice daily for five days. The primary
outcome was the occurrence of moderate to severe disease as defined by a
modified Vesikari scale score of 9 or higher within 14 days. The proportion of
children with moderate to severe disease was similar between groups. After
adjustment for trial site, age, and pre-enrollment frequency of vomiting and
diarrhea, the treatment assignment did not predict moderate to severe disease. The authors conclude that in children presenting to the emergency department
with gastroenteritis, twice daily administration of a Lactobacillus rhamnosus, Lactobacillus helvetica’s probiotic combination did not prevent
the development of moderate to severe disease within 14 days. Full trial
results are available at NEJM.org.

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