Systematic Review with Meta-Analysis: Lactobacillus reuteri DSM 17938 for Treating Acute Gastroenteritis in Children. An Update
Abstract
:1. Introduction
2. Material and Methods
2.1. Inclusion Criteria for This Review
2.2. Search Methods for Identification of Studies
2.3. Collection of Data and Analysis
2.4. Assessment of Risk of Bias in Included Studies
2.5. Dealing with Missing Data
2.6. Assessment of Heterogeneity and of Reporting Biases
2.7. Data Synthesis (Statistical Methods)
2.8. Certainty of Evidence
3. Results
3.1. Risk of Bias in Included Studies
3.2. Main Effects
3.3. Subgroup and Sensitivity Analyses
3.4. Certainty of Evidence
4. Discussion
4.1. Principle Findings
4.2. Strengths and Limitations
4.3. Agreement and Disagreement with Other Studies or Reviews
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Study ID; Country | Participants (Exp/Cont) | Intervention— L. reuteri DSM 17938 (Dose; Duration) | Comparison | Inclusion Criteria | Sample Size Calculation | Funding | |
---|---|---|---|---|---|---|---|
Treatment of Acute Gastroenteritis | |||||||
1. | Dinleyici 2014; Turkey | 64/63 | 1 × 108 CFU; 5 days | No intervention | 3–60 months; acute diarrhea (no definition) lasting 12–72 h; mild to moderate dehydration; hospitalization | Yes | The study was not funded (except for the free medication) |
2. | Dinleyici 2015; Turkey | 29/31 | 1 × 108 CFU; 5 days | No intervention | 3–60 months; acute diarrhea (≥3 loose or watery stools per 24 h) lasting 12–72 h; outpatients | Yes | Not described |
3. | Francavilla 2012; Italy | 35/34 | 4 × 108 CFU; 7 days | Placebo (mixture of sunflower oil and medium-chain triglyceride oil) | Age 6–36 months; acute diarrhea (≥2 or watery stools per 24 h) of no more than 7 days duration; mild to moderate dehydration; hospitalization | Yes | Not described |
4. | Szymański 2019; Poland | 44/47 | 2 × 108 CFU; 5 days | Placebo | Age < 5 years; acute gastroenteritis (a change in stool consistency to a loose or liquid form [according to the BSF scale, or, in the case of infants, the ASF scale] and/or an increase in the frequency of evacuations, typically ≥ 3 in 24 h), lasting no longer than 5 days. | Yes | BioGaia provided the study products. The study received no external funding. |
Patient or Population: Acute Gastroenteritis in Children Setting: Intervention: Lactobacillus reuteri DSM 17938 Comparison: Placebo/No Treatment | ||||||
---|---|---|---|---|---|---|
Outcomes | Anticipated Absolute Effects * (95% CI) | Relative Effect (95% CI) | № of Participants (Studies) | Certainty of the Evidence (GRADE) | Comments | |
Risk With Placebo/No Treatment | Risk With Lactobacillus Reuteri DSM 17938 | |||||
Lactobacillus reuteri DSM 17938 vs control. Duration of diarrhea (days) | The mean lactobacillus reuteri DSM 17938 vs control. Duration of diarrhea (days) ranged from 0.64 to 2.34 days | MD 0.87 days lower (1.43 lower to 0.31 lower) | - | 347 (4 RCTs) | ⨁◯◯◯ VERY LOW a,b,c,d | |
Lactobacillus reuteri DSM 17938 vs. control. Duration of hospitalization | The mean lactobacillus reuteri DSM 17938 vs. control. Duration of hospitalization ranged from 2.55 to 5.46 days | MD 0.54 days lower (1.09 lower to 0) | - | 284 (3 RCTs) | ⨁◯◯◯ VERY LOW d,e,f,g | |
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect |
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Patro-Gołąb, B.; Szajewska, H. Systematic Review with Meta-Analysis: Lactobacillus reuteri DSM 17938 for Treating Acute Gastroenteritis in Children. An Update. Nutrients 2019, 11, 2762. https://doi.org/10.3390/nu11112762
Patro-Gołąb B, Szajewska H. Systematic Review with Meta-Analysis: Lactobacillus reuteri DSM 17938 for Treating Acute Gastroenteritis in Children. An Update. Nutrients. 2019; 11(11):2762. https://doi.org/10.3390/nu11112762
Chicago/Turabian StylePatro-Gołąb, Bernadeta, and Hania Szajewska. 2019. "Systematic Review with Meta-Analysis: Lactobacillus reuteri DSM 17938 for Treating Acute Gastroenteritis in Children. An Update" Nutrients 11, no. 11: 2762. https://doi.org/10.3390/nu11112762