Anand Prakash Dubey
Professor of Pediatrics at ESI PGIMSR, New Delhi
Title: Do probiotics affect the course of acute watery diarrhea in children?
Biography
Biography: Anand Prakash Dubey
Abstract
Rapid rehydration, zinc and realimentation remain the cornerstone of management of acute diarrhea. However, researchers have tried other interventions like probiotics for better management as the standard therapy does not significantly reduce the duration of diarrhea. We studied the efficacy of Saccharomyces boulardii as an adjunct to standard therapy in reducing the duration of diarrhea and hospital stay. Efficacy of S boulardii is attributed to a direct inhibitory effect on growth of pathogenic strains, anti-secretory effect by specifically binding toxins to intestinal receptors, and trophic effect on enterocytes with stimulation of enzymatic activity and non-specific anti-infectious mechanisms.
This was an open labelled randomized control trial enrolling 100 cases of acute diarrhea aged 2 – 60 months. Informed consent was taken from caregivers of child before enrolment. Child with acute watery diarrhea with no dehydration was enrolled at admission. Child with some/severe dehydration was enrolled after dehydration correction. Enrolled subjects had undergone simple randomization through serial numbered opaque sealed envelopes. 50 patients were treated with S. boulardii, 250 mg twice daily for 5 days with ORS and zinc (group A) and 50 were given ORS and zinc alone (group B). Duration of diarrhea and consistency and frequency of stools were recorded every morning. Diarrhea was considered to have stopped when child passed <3 stools/day or stool with a formed consistency only. We found that the difference in mean no. of stools and mean duration of diarrhea between the two groups was statistically significant (p value=<0.001). The mean difference in duration of diarrhea of 37.8 hrs. and the mean difference in duration of hospitalization between the two groups of 38.4 hours was also statistically significant ( p value = <0.001).