Effectiveness of Lactobacillus rhamnosus GG as an adjunct in the treatment of enteric fever in children: A double-blinded randomized controlled trial in Southern India

Abstract

Introduction: A probiotic used as an adjunct in Salmonella typhi infection along with antibiotic is postulated to interfere with the virulence and growth of Salmonella. To determine the effectiveness of Lactobacillus rhamnosus GG (LGG), as an adjunct with intravenous ceftriaxone, compared with a placebo in defervescence and toxemia resolution in children with enteric fever. Settings and Design: This hospital-based randomized double-blinded controlled trial was conducted among 56 study participants who were children below the age of 12 years, admitted as inpatients with fever and whose blood culture grew S. typhi. Materials and Methods: Study participants were equally allocated into intervention or control group by simple randomization. The intervention group received injection ceftriaxone and oral LGG (probiotic) for 7 days while the control group received an injection ceftriaxone and oral placebo for 7 days. Statistical Analysis: Kaplan–Meier curves and mantel cox log-rank test were used to compare the duration for defervescence and toxemia resolution after treatment initiation. Results: Mean duration for defervescence in the intervention and control groups was 3.87 (1.57) days and 3.35 (1.19) days, respectively. The mean time taken for the resolution of toxemia was 3.00 (1.15) days in the intervention group and 2.64 (0.87) days in the control group. Conclusions: The addition of oral LGG at a dose of 3 × 109 colony-forming units for 7 days to the standard antibiotic therapy for enteric fever did not show a significant reduction in the time taken for defervescence (P = 0.099) or resolution of toxemia (P = 0.148).