Bacillus clausii for the Treatment of Acute Diarrhea in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Acute diarrhea is a burdensome disease with potentially harmful consequences, especially in childhood. Despite its large use in clinical practice, the efficacy of the probiotic Bacillus clausii in treating acute childhood diarrhea remains unclear. Our objective was to systematically review the efficacy of Bacillus clausii in the treatment of acute childhood diarrhea. The following electronic databases were systematically searched up to October 2017: MEDLINE (via PubMed/OVID), EMBASE (via OVID), Cochrane Central Database of Controlled Trials (via CENTRAL), Google Scholar, and ClinicalTrials.gov. Only randomized controlled trials were included. The overall effect for the meta-analysis was derived by using a random effects model. Six randomized controlled trials (1298 patients) met the eligibility criteria. Data arising from pooled analysis showed that Bacillus clausii significantly reduced the duration of diarrhea (mean difference = −9.12 h; 95% confidence interval [CI]: −16.49 to −1.75, p = 0.015), and the duration of hospitalization (mean difference = −0.85 days; 95% CI: −1.56 to −0.15, p = 0.017), compared with control. There was a trend of decreasing stool frequency after Bacillus clausii administration compared with the control group (mean difference = −0.19 diarrheal motions; 95% CI: −0.43 to −0.06, p = 0.14). Bacillus clausii may represent an effective therapeutic option in acute childhood diarrhea, with a good safety profile.

Anti-microbial susceptibility pattern of spores used in Bacillus clausii suspension: an in vitro study

“…21 The authors also reported that the administration of B. clausii preparations significantly reduced the duration of hospitalization by a mean of 0.85 days compared to controls (p = 0.017). 21 This is important considering that in low-income countries, children under three years old experience on average three episodes of diarrhea every year. 21,23 Marseglia et al, performed a pilot study to assess the efficacy and the safety of B. clausii in the prevention of recurrent respiratory infections in children.…”

“…9,12,20 B. clausii, probiotic in the spore form appears to have an important role to play management of acute diarrhea and recurrent respiratory infections in children, with a good safety profile. 21,22 A systematic review and a metaanalysis of randomized controlled trials of B. clausii in acute childhood diarrhea by Ianiro et al, showed that the mean duration of diarrhea was reduced by 9.12 hours with B. clausii treatment, as compared to controls (p=0.015). 21 The authors also reported that the administration of B. clausii preparations significantly reduced the duration of hospitalization by a mean of 0.85 days compared to controls (p = 0.017).…”

“…21,22 A systematic review and a metaanalysis of randomized controlled trials of B. clausii in acute childhood diarrhea by Ianiro et al, showed that the mean duration of diarrhea was reduced by 9.12 hours with B. clausii treatment, as compared to controls (p=0.015). 21 The authors also reported that the administration of B. clausii preparations significantly reduced the duration of hospitalization by a mean of 0.85 days compared to controls (p = 0.017). 21 This is important considering that in low-income countries, children under three years old experience on average three episodes of diarrhea every year.…”

“…21 This is important considering that in low-income countries, children under three years old experience on average three episodes of diarrhea every year. 21,23 Marseglia et al, performed a pilot study to assess the efficacy and the safety of B. clausii in the prevention of recurrent respiratory infections in children. 22 Results showed that B. clausii treatment was significantly effective (p=0.037) in reducing the duration of respiratory infections in children with recurrent disease.…”

Comparative study of Bacillus clausii and multistrain probiotics in the management of acute diarrhoea in children

“…15 Another study conducted by Jayanthi N et al, supported the use of Bacillus clausii in pediatric diarrhoea. 16 Lahiri et al, conducted a study on Bacillus clausii in pediatric acute diarrhoea and it showed reduction of diarrhoeal duration, and hospital stay but it was regarded as poor quality by meta-analysis done by Ianiro et al 15,17 However, another most recent study conducted by Freedman SB et al, in Canada concluded that Lactobacillus rhamnosus and L. helveticus did not have a role in pediatric diarrhoea. 18 A study done in USA using Lactobacillus rhamnosus did not show better outcome than placebo.…”