Your browser has 'Cookies' disabled, alert boxes will continue to appear without this feature.

Probiotics for Acute infectious diarrhoea


There may be a significant difference between the pharmaceutical-grade probiotics that show promise in clinical trials and probiotics in foodstuffs.


Intervention

Oral probiotics taken directly or mixed with food/fluid.

Indication

Episodes of acute infectious diarrhoea, particularly in children (there are few studies involving adults), aiming to shorten the duration of diarrhoea and reduce stool frequency.

When used in conjunction with oral rehydration, probiotics have been shown to reduce the duration of diarrhoea by around 25 hours, decrease the risk (by almost 60%) of diarrhoea lasting longer than four days; and reduce the frequency of diarrhoea on day 2 after the intervention. Due to the marked variability in study findings, these figures are approximate.

Probiotics have several actions in the gut, including actively competing with pathogens for nutrition, making gut contents acidic, secreting local antimicrobial agents, and enhancing specific and non-specific immune responses.

Precautions

Evidence suggests that probiotics are safe for the vast majority of people. As there is a very small risk of sepsis, these agents should potentially be avoided in patients who are immunocompromised, severely debilitated, critically ill or postoperative.

Adverse effects

Probiotics are not associated with serious adverse effects. Some people experience bloating and diarrhoea.

Availability

Many different formulations of probiotics (capsules, powders, sachets) are available from supermarkets, pharmacies and health food stores. Products containing probiotics that are classed as foodstuffs (eg yoghurt) are not subjected to the same rigorous processes for labelling and listing as those applied to medicines.

There do not appear to be important differences in probiotic effect related to choice of probiotic strain, the number of different strains included, the viability of the organisms, or whether low-dose or high-dose preparations are used.

Description

The ESPGHAN Working Group for Probiotics and Prebiotics recommends the types of probiotics that may be considered (in addition to rehydration treatment) for the management of acute infectious diarrhoea in children include Lactobacillus rhamnosus GG, Saccharomyces boulardii, Lactobacillus reuteri DSM 17938 and heat-inactivated Lactobacillus acidophilus LB.

Probiotics may be taken alone or with food/fluid according to the manufacturer’s directions. The ideal duration of treatment has not been established, however 5–10 days appears to be appropriate.

Tips and challenges

The use of probiotics for acute infectious diarrhoea may be particularly useful for parents travelling with children. Products that do not require refrigeration are more convenient; however, it is difficult to single out a particular product.

Grading

NHMRC Level I evidence.

References

Advertisement loading...

Advertisement


Interact with HANDI

About HANDI

Interventions

Children

Nutrition

Cardiovascular

Mental health

Musculoskeletal

Other

The Royal Australian College of General Practitioners

Contact Us

General Inquiries

General Enquiries

Opening hours 8:00 am-8:00 pm AEST

1800 4RACGP

1800 472 247 | +61 (3) 8699 0300 (international)

Payments

Payments

Pay invoices online

RACGP automated payment service: 1800 198 586

Follow us on

Follow RACGP on Twitter Follow RACGP on Facebook Follow RACGP on LinkedIn


Healthy Profession. Healthy Australia Logo

The Royal Australian College of General Practitioners (RACGP) ABN 34 000 223 807
RACGP House, 100 Wellington Parade, East Melbourne, Victoria 3002 Australia

Terms and conditions | Privacy statement
Sponsor conditions | Delegate conditions