Use of Probiotics for the Management of Acute Gastroenteritis in Children: An Update
Open accessAbstract
Since the publication of the 2014 European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Working Group (WG) on Probiotics and Prebiotics guidelines for the management of acute gastroenteritis (AGE), new evidence concerning the efficacy of probiotics has become available. This document provides updated recommendations on the use of probiotics for the treatment of AGE in previously presumed healthy infants and children. A systematic literature search was performed. All pooled analyses were explicitly performed for the current report. The WG graded the recommendations and assessed the certainty of the supporting evidence using the Grading of Recommendations, Assessment Development, and Evaluations tool. The recommendations were formulated if at least 2 randomized controlled trials that used a given probiotic were available. Despite the large number of identified trials, the WG could not identify 2 randomized controlled trial of high quality for any strain that provided benefit when used for treating AGE. The WG made weak recommendations for (in descending order in terms of the number of trials evaluating any given strain): Saccharomyces boulardii (low to very low certainty of evidence); Lactobacillus rhamnosus GG (very low certainty of evidence); L reuteri DSM 17938 (low to very low certainty of evidence); and L rhamnosus 19070-2 and L reuteri DSM 12246 (very low certainty of evidence). The WG made a strong recommendation against L helveticus R0052 and L rhamnosus R0011 (moderate certainty of evidence) and a weak recommendation against Bacillus clausii strains O/C, SIN, N/R, and T (very low certainty of evidence).
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Among viral indications, probiotics have been most extensively studied in the management of viral diarrhea and upper respiratory tract infections, and generally the evidence supporting their efficacy and safety is positive.
“Among these indications probiotics have been most extensively studied in the management of viral diarrhea (Szajewska et al., 2020) and URTIs (Hao et al., 2015) and, generally, the evidence supporting their efficacy and safety are positive.”
From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Szajewska et al., 2020
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- Authors
- Szajewska, H., Guarino, A., Hojsak, I., Indrio, F., Kolacek, S., Orel, R., Salvatore, S., Shamir, R., van Goudoever, J. B., Vandenplas, Y., Weizman, Z., Zalewski, B. M., & Working Group on Probiotics and Prebiotics of the European Society for Paediatric Gastroenterology, H. A. N.
- Affiliations
- Medical University of Warsaw (PL)
- Federico II University Hospital (IT)
- University of Zagreb (HR)
- Ospedale Pediatrico Giovanni XXIII (IT)
- Children's Hospital Zagreb, University of Zagreb School of Medicine University J.J. Strossmayer School of Medicine Osijek Croatia
- Ljubljana University Medical Centre (SI)
- University of Insubria (IT)
- Tel Aviv University (IL)
- Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam Emma Children's Hospital Paediatrics Amsterdam The Netherlands
- Vrije Universiteit Brussel (BE)
- Ben-Gurion University of the Negev (IL)
- Corresponding author
- Szajewska, Hania
- Zalewski, Bartłomiej M.
- ORCID
- Venue
- Journal of Pediatric Gastroenterology and Nutrition
- Publisher
- Wiley
- Published
- 2020-04-28
- Volume
- 71
- Issue
- 2
- Pages
- 261-269
- ISSN
- 0277-2116 (ISSN-L)
- 1536-4801
- OpenAlex
- W3018540606
- Cited by
- 90
- References
- 79
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 15 · 2023: 15 · 2022: 22 · 2021: 15 · 2020: 4
- FWCI
- 9.08
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- Journal of Pediatric Gastroenterology and Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- AIRUS (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- probiotics, acute gastroenteritis, children, infants, Saccharomyces boulardii, Lactobacillus rhamnosus GG, Lactobacillus reuteri, Lactobacillus helveticus, Bacillus clausii, treatment guidelines, quality of evidence
- MeSH terms
- Child, Diarrhea, Gastroenteritis, Humans, Infant, Practice Guidelines as Topic, Probiotics, Limosilactobacillus reuteri, Lacticaseibacillus rhamnosus
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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