Rethinking Treatment for Acute Pediatric Gastroenteritis

Acute pediatric gastroenteritis, also known as infectious diarrhea, can cause vomiting and abdominal pain, and is responsible for some 1.7 million emergency room visits annually in the US. Current treatment protocol suggests the use of probiotics, but findings from a new double-blind randomized controlled trial suggest that patient outcomes from those so treated may be no better than that achieved with placebo. Author Elizabeth Powell, MD, MPH, a specialist in pediatric emergency medicine at the Feinberg School of Medicine, Northwestern University remarked “Recommendations to use probiotics for these patients were based on previous meta-analyses that have suggested probiotics may be beneficial, but the trials that were included had significant limitations. This study presents the most robust evidence to date that use of probiotics does not improve outcomes of acute gastroenteritis in children…”

The trial, conducted at 10 pediatric emergency departments across the US, included 943 children aged 3 months to 4 years who presented with acute gastroenteritis. At 2 weeks post-visit, subjects who had received a 5-day course of probiotic (Lactobacillus rhamnosus) showed no differences from children who received placebo in severity or duration of their illness, or from symptoms including vomiting, diarrhea, or absence from daycare. Dr. Powell concluded that “The rigor of our research design and our results warrant reconsideration of common practice.” The findings were reported in the New England Journal of Medicine.

Read about the study. 

The journal abstract may be read here.