Efficacy of probiotics in reducing the duration and severity of acute gastroenteritis in children: A meta-analysis of randomized controlled trials.

Objectives: Acute gastroenteritis is a leading global health concern among children, causing significant morbidity and mortality. Despite advances in treatment, effective management remains a challenge. Probiotics aim to restore gut homeostasis by correcting intestinal dysbiosis. This systematic review and meta-analysis aims to assess the efficacy of probiotics in reducing the severity and duration of diarrhea in children with acute gastroenteritis.

Methods: A comprehensive literature search was conducted across four major databases using the keywords "acute diarrhea," "pediatric," and "probiotics," among others. Only double-arm randomized clinical trials (RCTs) were included, focusing on the efficacy of probiotics in treating pediatric acute diarrhea. Data analysis was performed using Stata 16.0, with a random-effects model applied to account for study variability.

Results: Out of 1470 studies screened, 25 RCTs involving 5170 patients (2552 in the probiotic group and 2618 in the placebo group) met the inclusion criteria. Probiotics significantly reduced the overall duration of diarrhea (mean difference [MD]: -7.76; 95% confidence interval [CI]: -14.60 to -0.91; p = 0.03). Diarrhea frequency was notably reduced on Day 2 (MD: -1.03; 95% CI: -2.06 to 0.00; p = 0.05) and Day 5 (MD: -0.51; 95% CI: -0.83 to -0.18; p = 0.002). Probiotics also significantly reduced the duration of vomiting (MD: -0.19; 95% CI: -0.28 to -0.09; p < 0.01), with a nonsignificant trend in fever reduction.

Conclusion: This meta-analysis demonstrates the clinical efficacy of probiotics in reducing the duration of diarrhea and vomiting in children with acute gastroenteritis. Future trials are recommended to further explore the role of specific probiotic strains and combinations to enhance treatment outcomes.