A Cochrane review included 4 studies with a total of 464 children with persistent diarrhoea (duration ≥ 14 days) that is proven (pathogens isolated from stools) or presumed to be caused by an infectious agent. All trials were conducted in hospitals and involved children up to the age of six years from middle-income countries. Probiotics reduced the duration of persistent diarrhoea by 4 days (table ). Stool frequency was reduced with probiotics in two trials: data from the three-arm study showed that on day 5, the stool frequency decreased to 2.0 ± 2.0 in the saccharomyces group and 1.5 ± 0.9 in the lactobacilli group, respectively, in comparison with placebo (5.2 ± 3.0), (P < 0.001). The data from another study showed a significant difference in stool frequency on day 5 during treatment between probiotic and placebo groups (5.2 ± 2.1 versus 10.2 ± 3.2). One study reported a shorter hospital stay (table ). No adverse events were reported.
| Outcome | Placebo | Probiotic (95% CI) | Participants (studies) |
|---|---|---|---|
| Duration of diarrhoea days | The mean duration of diarrhoea ranged across control groups from 8.5 to 9.2 days | The mean duration of diarrhoea in the intervention groups was 4.02 days lower (4.61 to 3.43 lower) | 324 (2 studies) |
| Hospital stay days | The mean hospital stay in the control groups was 15.5 days | The mean hospital stay in the intervention groups was 8.2 days lower (8.6 to 7.8 lower) | 235 (1 study) |
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and blinding).