Probiotics, gastroenteritis and Helicobacter

Probiotics, usually in the form of live Lactobacillus species, have become popular as both a treatment and a preventative agent for a wide variety of childhood conditions. For example, there is evidence that they work in antibiotic-related diarrhoea, necrotising enterocolitis and possibly infantile colic. So if the diarrhoea that occurs in straightforward viral gastroenteritis is partly due to an altered intestinal microbiome, would you expect them to help this as well? You might, but two robust new studies suggest that they don’t. The NEJM published two large randomised double-blind placebo-controlled trials simultaneously.

The first, from Canada, involved nearly 900 children aged 3 months to 4 years presenting to one of 6 children’s emergency departments (EDs) with between 24 and 72 hours of diarrhoea and vomiting, with at least 3 loose stools a day (Freedman S et al. 2018. doi:10.1056/NEJMoa1802597). Cases received sachets containing lyophilised Lactobacillus rhamnosus R0011 and L....

from Archives of Disease in Childhood current issue http://bit.ly/2RNcA9x