Probiotics in infectious diarrhoea in children

• probiotics are products containing viable micro-organisms taken with the intention of altering the person's intestinal microflora in an attempt to improve health or treat disease
  • they can include one or more species of bacteria
    • most commonly Lactobacillus and Bifidobacterium species (both part of normal human intestinal flora) or, less commonly, yeasts such as Saccharomyces species
  • possible mechanisms for beneficial effects include modulating the activity of immune cells in the intestinal mucosa and submucosa; and displacing, or suppressing the growth of, enteric pathogens in the gastrointestinal tract by competing for nutrients or binding sites, or producing antimicrobial chemicals
  • note that there have been a few reports of severe infections arising from probiotic ingestion (usually in debilitated or immunosuppressed patients)
• evidence suggests that probiotics can reduce the duration of acute infectious diarrhoea in children by almost a day (1)
• European guidelines currently recommend the use of L. rhamnosus GG ATCC53103, S. boulardii CNCM I-745, L. reuteri DSM 17938, L. rhamnosus 19070-2 and L. reuteri DSM 12246 in the treatment of acute gastroenteritis in children (2)

Reference

1. Depoorter L et al. Probiotics in Pediatrics. A Review and Practical Guide. Nutrients. 2021 Jun 24;13(7):2176
2. Szajewska H et al. Use of Probiotics for the Management of Acute Gastroenteritis in Children: An Update. J. Pediatr. Gastroenterol. Nutr. 2020;71:261–269