The Role of Prebiotics and Probiotics in Prevention and Treatment of Childhood Infectious Diseases

Stefan Weichert, MD; Horst Schroten, MD; Rüdiger Adam, MD


Pediatr Infect Dis J. 2012;31(8):859-862. 

In This Article

Treatment of Acute Diarrhea

The role of probiotics in the treatment of acute (viral) gastroenteritis in infants and children has been investigated by a large number of clinical trials, which led to recommendations by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Infectious Diseases that selected probiotics with proven clinical efficacy and administered in appropriate dosages, according to the strain and the patient population, might be used as an adjunct to rehydration therapy for the management of acute (viral) gastroenteritis in children.[23] In a recently published Cochrane systematic review, including 56 studies with children, the authors conclude that probiotics have clear beneficial effects in shortening the duration of acute infectious diarrhea by a median of 24.76 hours (95% CI: 15.9–33.6 hours; 35 trials; >4500 participants) and in reducing mean stool frequency on day 2 (mean difference 0.8; 0.45–1.14; 20 trials; >2700 participants).[24] Results from an updated meta-analysis of RCTs investigating the impact of Saccharomyces boulardii on treatment of acute (viral) gastroenteritis in children also demonstrated a reduction in the duration of diarrhea by a median of 1.08 days (95% CI: −1.64 to −0.53); 5 RCTs; 944 participants) in the probiotic intervention group compared with the control group.[25]

It is interesting to note that S. boulardii in combination with metronidazole was also found to decrease the duration of bloody diarrhea in children with amebiasis when compared with metronidazole alone (42.2 14;± 14;17.4 hours versus 72.0 14;± 14;28.5 hours; P < 0.001).[26] In this context, it was also recently demonstrated that human milk oligosaccharides, which serve as models for artificially synthesized prebiotics like galactooligosaccharides and fructooligosaccharides, reduced attachment and cytotoxicity of Entamoeba histolytica in a human cell culture model. Of note, in the same setting similar effects could be shown with galactooligosaccharides.[27]


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