Prophylactic efficacy of probiotics on travelers’ diarrhea: An adaptive meta-analysis of randomized controlled trials
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OBJECTIVES: The 2017 guideline for the prevention of travelers' diarrhea (TD) by the International Society of Travel Medicine suggested that 'there is insufficient evidence to recommend the use of commercially available prebiotics or probiotics to prevent or treat TD.' However, a meta-analysis published in 2007 reported significant efficacy of probiotics in the prevention of TD (summary relative risk [sRR], 0.85, 95% confidence interval [CI], 0.79 to 0.91). This study aimed to synthesize the efficacy of probiotics on TD by updating the meta-analysis of double-blind, placebo-controlled, randomized human trials. METHODS: The search process was conducted by the adaptive meta-analysis method using the 'cited by' and 'similar articles' options provided by PubMed. The inclusion criteria were double-blind, placebo-controlled, randomized human trials with hypotheses of probiotics as intervention and TD as an outcome. The adaptive meta-analysis was conducted using Stata software using the csi, metan, metafunnel, and metabias options. RESULTS: Eleven articles were selected for the meta-analysis. The sRR was 0.85 (95% CI, 0.79 to 0.91) and showed statistical significance. There was no heterogeneity (I-squared=28.4%) and no publication bias. CONCLUSIONS: Probiotics showed statistically significant efficacy in the prevention of TD.
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There is substantial evidence in the literature of the beneficial effects of probiotics on diarrhea, especially the prevention of traveler's diarrhea and the treatment of acute diarrhea in children.
“There is substantial evidence in the literature of the beneficial effects of probiotics on diarrhea, especially the prevention of traveler’s diarrhea [105,106] and the treatment of acute diarrhea in children [107].”
From The Potential Impact of Probiotics on Human Health: An Update on Their Health-Promoting Properties (2024) · cites this paper as [105]
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The Potential Impact of Probiotics on Human Health: An Update on Their Health-Promoting Properties
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- Authors
- Bae, J.-M.
- Affiliations
- Jeju National University (KR)
- Corresponding author
- Bae, Jong-Myon
- Venue
- Epidemiology and Health
- Publisher
- Korean Society of Epidemiology
- Published
- 2018-08-29
- Volume
- 40
- Pages
- e2018043
- ISSN
- 1225-3596 (ISSN-L)
- 2092-7193
- PMC
- PMC6232657
- OpenAlex
- W2889376193
- Cited by
- 37
- References
- 19
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 7 · 2021: 5 · 2020: 5 · 2019: 6
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Epidemiology and Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Travel-related health issues
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- probiotics, traveler's diarrhea, diarrhea prevention, prebiotics, publication bias, heterogeneity
- MeSH terms
- Diarrhea, Humans, Travel, Randomized Controlled Trials as Topic, Treatment Outcome, Probiotics
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