Antidiarrheal effect of Psidium guajava L. extract in acute diarrhea: a systematic review

Abstract

BackgroundAcute diarrheal diseases are a leading cause of childhood mortality and morbidity worldwide. Psidium guajava has been globally used for its antidiarrheal potential. Carry out a systematic review of scientific articles published up to the year 2021, which included in vivo pre‐clinical tests and clinical trials involving patients with acute infectious diarrhea to verify the antidiarrheal, antibacterial, and antispasmodic effects of galenic preparations or phytopharmaceuticals from P. guajava. PRISMA and Rayyan were used as tools for the selection of studies collected in four databases (Pubmed, Scopus, Web of Science, and Science Direct). The keywords used to carry out the search were: "Psidium guajava", "guava", "antidiarrhea*", "diarrhe*", joined by Boolean operators "OR" or "AND". The characteristics of studies in animal models of acute diarrhea induction, as well as in vivo and in vitro motility and microbiological tests linked with its main pathophysiological mechanisms, were collected.Results and ConclusionTwenty‐three articles were included. Twenty (87%) of theirs reported heterogenic preclinical studies, predominating pharmacological studies of efficacy against conventional antidiarrheal agents, which utilized relevant outcomes and models of infectious diarrhea from the top pathogens in the clinic along with classical castor oil‐induced diarrhea associated with motility tests. Only three of them (13%) corresponded to clinical trials to study the efficacy, dose, and safety of these preparations. Most studies reported positive results and significant mechanistic evidence from antibacterial, anti‐motility, anti‐secretory, and protective/anti‐inflammatory perspectives. However, further studies are needed to define the clinical significance and safety treatment with P. guajava extracts.This article is protected by copyright. All rights reserved.