Not all commercially available probiotics are effective in children with acute diarrhea, according to this study from researchers at the University of Naples Federico II in Italy.

First, the details. 571 children aged 3-36 months visiting a pediatrician for acute diarrhea were randomly assigned to treatment.

  • Oral rehydration solution
  • Lactobacillus rhamnosus strain GG
  • Mix of 4 bacterial strains (L delbrueckii var bulgaricus, Streptococcus thermophilus, L acidophilus, and Bifidobacterium bifidum)
  • Saccharomyces boulardii
  • Bacillus clausii
  • Enterococcus faecium SF68

And, the results.

  • Median (the middle) duration of diarrhea was significantly shorter with L rhamnosus strain GG (79 hours) and the mix of 4 bacterial strains (70 hours) compared to children given the oral rehydration solution alone (115.0 hours).
  • Also, a day after the first probiotic administration, the daily number of stools was significantly lower in children given L rhamnosus strain GG or the probiotic mix vs the other groups.
  • The other treatments did not affect outcomes.

The bottom line?
Compared to rehydration, the effective treatments shortened the duration of diarrhea by about a day-and-a-half to almost 2 days. By comparison, in an earlier study discussed here, there was less than one-day difference in the duration of diarrhea between those taking a homeopathic remedy vs placebo. To be fair, it should be stated that these were different studies, conducted continents apart.

Prof. Jeanne Pawitan from the University of Indonesia in Jakarta comments in an accompanying letter, it must be “assumed that the cause was infection or food poisoning, as other causes such as food allergy or cystic fibrosis were excluded. However, microbiological examination was performed only when there were specific clinical reasons, so that no complete information was available.”

From a practical perspective, “Probiotics should be used cautiously in children. Sepsis caused by Lactobacillus GG has been reported in 2 children hospitalized with diarrhea as a result of antibiotic treatment for other diseases.”

8/31/07 09:51 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.