Effect of probiotics supplementation on acute diarrhea in infants: a randomized double blind clinical trial

Background Probiotics has advantages as a supplement for management of infants with acute diarrhea. It influences the duration of diarrhea by enhancing immune responses, elaborates antimicrobial substances and occupies intestinal mucosal sites, inhibits the attachment and the growth of pathogenic organisms by achieving competitive exclusion and microbial balance. Objective To assess the clinical effects of probiotics supplementation on acute diarrhea in infants. Methods This was a double blind, randomized clinical controlled trial performed on infants aged 1-12 months old with acute diarrhea, hospitalized in Sanglah Hospital, Denpasar. Subjects were divided into two groups; the treatment group had standard management with adjuvant probiotics, while the control group received standard management with placebo. Results From 70 infants enrolled in this study, the mean duration of diarrhea in treatment group was significantly shorter than that in the placebo group, 49.03 hours (SE 3.09) (95%CI 42.98;55.08) vs 73.03 hours (SE 3.28) (95%CI 66.61;79.45); P=0.001. Regarding failure of the treatment, probiotics supplementation had relative risk reduction (RRR) of 67% and absolute risk reduction (ARR) of 57%. In multivariate cox regression analysis it was found that only probiotics supplementation influenced the duration of acute diarrhea in infants. Conclusion Probiotics can shorten the duration of acute diarrhea, and is safe as an adjuvant to standard management for infants with acute diarrhea