Effect of probiotics supplementation on acute diarrhea in infants: a randomized double blind clinical trial
Keywords:
Acute diarrhea, probiotics, duration of diarrhea
Abstract
Background Probiotics has advantages as a supplement formanagement of infants with acute diarrhea. It influences the
duration of diarrhea by enhancing immune responses, elaborates
antimicrobial substances and occupies intestinal mucosal sites,
inhibits the attachment and the growth of pathogenic organisms
by achieving competitive exclusion and microbial balance.
Objective To assess the clinical effects of probiotics supplementation
on acute diarrhea in infants.
Methods This was a double blind, randomized clinical controlled
trial performed on infants aged 1-12 months old with acute
diarrhea, hospitalized in Sanglah Hospital, Denpasar. Subjects
were divided into two groups; the treatment group had standard
management with adjuvant probiotics, while the control group
received standard management with placebo.
Results From 70 infants enrolled in this study, the mean duration
of diarrhea in treatment group was significantly shorter than that
in the placebo group, 49.03 hours (SE 3.09) (95%CI 42.98;55.08)
vs 73.03 hours (SE 3.28) (95%CI 66.61;79.45); P=0.001.
Regarding failure of the treatment, probiotics supplementation
had relative risk reduction (RRR) of 67% and absolute risk
reduction (ARR) of 57%. In multivariate cox regression analysis
it was found that only probiotics supplementation influenced the
duration of acute diarrhea in infants.
Conclusion Probiotics can shorten the duration of acute diarrhea,
and is safe as an adjuvant to standard management for infants
with acute diarrhea.
References
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Lactobacillus therapy for acute infectious diarrhea in
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Denpasar: SMF IKA FK UNUD; 2002. p. 1-24.
2. Irwanto, Abdul Rohim, Subijanto Marto Sudarmo. Diare
akut pada anak. In: Soegeng Soegijanto, editor. Ilmu penyakit
anak diagnosa dan penatalaksanaan. 1 st ed. Jakarta: Salemba
Medika; 2002. p. 73-8.
3. Profil kesehatan Indonesia 2001, 2002. Departemen
Kesehatan Republik Indonesia, Jakarta. Cited 2004 Oct 4.
Available from: url: http// www. Depkes.go.id.
4. Departemen Kesehatan RI. Epidemiologi dan etiologi diare.
In : Buku ajar diare. Jakarta: Departemen Kesehatan RI,
Direktorat Jendral Pemberantasan Penyakit Menular dan
Penyehatan Lingkungan Pemukiman (Ditjen P2M & PLP);
1995. p. 3-136.
5. Subijanto Marto Sudarmo, Reza Gunadi Ranuh. Peranan
prebiotik dan probiotik dalam upaya pencegahan diare pada
anak. Presented at Continuing Education XXX. Lab IKA FK
UNAIR/RSUD Dr. Soetomo–IDAI Cabang Jawa Timur.
Surabaya, July 30, 2000.
6. Abdul Rohim, Subijanto Marto Sudarmo. Probiotik dan flora
normal usus. In: Soegeng Soegijanto, editor. Ilmu penyakit
anak diagnosa dan penatalaksanaan. 1 st ed. Jakarta: Salemba
Medika; 2002. p. 93-101.
7. Rolfle RD. The role of probiotic cultures in the control of
gastrointestinal health. Presented at Symposium: Probiotic
Bacteria implications for human health. American Society
Nutritional Sciences. Washington, April 17-21, 2000.
8. Pitono Soeparto, Liek S Djupri, Subijanto Marto Sudarmo.
Gangguan absorpsi sekresi, sindroma diare. 2 nd ed. Surabaya:
Gramik; 1999. p. 37-76.
9. Noerasid H, Suraatmaja S, Asnil PO. Gastroenteritis (Diare) akut.
In: Suharyono, Boediarso A, Halimun, editors. Gastroenterologi
anak praktis. Jakarta: Balai Penerbit FK UI; 1988. p. 51-96.
10. Agus Firmansyah. Terapi Probiotik dan prebiotik pada
penyakit saluran cerna anak. Sari Pediatri 2001;2:210-3.
11. Isolauri E, Juntunen M, Rautanen T, Silanaukee P, Koivula
T. A human lactobacillus strain (lactobaccillus casei sp strain
GG) promotes recovery from acute diarrhea in children.
Pediatrics 1991;88:90-7.
12. Bernet MF, Brassart D, Neeser JR, Servin AL. Lactobacillus
acidophillus LA 1 binds to cultured human intestinal cell
lines and inhibits cel attachment and cell invasion by
enterovirulent bacteria. Gut 1994;35:483-9.
13. Jose M Saavedra, Adel Abi–Hanna. Clinical Studies of
Probiotic Agent. In: Hanson LA, Yolken RH, editors.
Probiotics other nutritional factor, and intestinal mikroflora.
Philadelphia: Nestec Ltd; 1999. p. 271-86.
14. Simakachorn N, Pichaipat V, Rithipompaisam P, Kongkaew
C, Tongpradit P, Varavithya W. Clinical evaluation of addition
of lyophilized, heat killed lactobacillus acidophilus LB to oral
rehydration therapy in the treatment of acute diarrhea in
children. J Pediatr Gastroenterol Nutr 2000;30:68-72.
15. Shornikova AV, Isolauri E, Burkanova L, Lukovnikova S,
Vesikari T. A trial in the Karelian Republic of oral rehydration
and lactobacillus GG for treatment of acute diarrhea. Acta
Pediatr 1977;86:460-5.
16. Guandalin S, Pensabene L, Zikri MA. Lactobacillus GG
administered in oral rehydration solution to children with
acute diarrhea: A Multicenter European Trial. J Pediatr
Gastroenterol Nutr 2000;30:54-60.
17. Shornikova AV, Casas IA, Isolauri E, Mykkanen H, Vesikari
T. Lactobacillus reuteri as a therapeutic agent in acute
diarrhea in young children. J Pediatr Gastroenterol Nutr
1977;24:399-401.
18. Nisa Tri Rini, Rusdi Ismail, Achirul Bakri, Prambudi R. The
influence of lactobacillus on duration and frequency of acute
diarrhea in the pediatric in patient M.Hoesin Hospital.
Presented at 12 th National congress of child health and 11 th
Asean pediatric federation coference. June 30 - July 4,
2002.Denpasar (Abstract).
19. Van Niel CW, Feudtner C, Garrison MM, Christakis DA.
Lactobacillus therapy for acute infectious diarrhea in
Children: A Meta-analysis. J Pediatr 2002;109:34-8.
Published
2007-08-31
How to Cite
1.
Sanjaya Putra IG, Suraatmaja S, Aryasa IK. Effect of probiotics supplementation on acute diarrhea in infants: a randomized double blind clinical trial. PI [Internet]. 31Aug.2007 [cited 30Nov.2024];47(4):172-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/394
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Received 2016-08-30
Accepted 2016-08-30
Published 2007-08-31
Accepted 2016-08-30
Published 2007-08-31
