Clinical Efficacy of Saccharomyces boulardii and Metronidazole Compared to Metronidazole Alone in Children with Acute Bloody Diarrhea Caused by Amebiasis: A Prospective, Randomized, Open Label Study

Abstract

The aim was to evaluate the efficacy of Saccharomyces boulardii (Sb) in addition to metronidazole in amebiasis. A prospective, randomized, open clinical trial was performed in 50 children presenting with acute bloody diarrhea caused by Entameba histolytica. Group A and B (each N = 25) was treated with metronidazole, but Sb (250 mg, twice daily) during the 7 days was added to Group B patients who were re-evaluated 2, 3, 5, 10, and 30 days after diagnosis. Duration of bloody diarrhea was significantly longer in Group A (72.0 +/- 28.5 versus 42.2 +/- 17.4 hours, P < 0.001). On day 5, amebic cysts had disappeared in all children in Group B, whereas in Group A, amebic cysts were still present in 6 children (P < 0.05). On day 10, all children were cured and cysts had disappeared in all. The addition of Sb to metronidazole in amebiasis significantly decreases duration of (bloody) diarrhea and enhances clearance of cysts.

Clinical Efficacy Comparison of Saccharomyces boulardii and Yogurt Fluid in Acute Non-Bloody Diarrhea in Children: A Randomized, Controlled, Open Label Study

“…5 Also bloody diarrhea due to amebiasis in children is shortened in comparison to placebo when S. boulardii is added to metronidazole. 12 Yogurt is a coagulated fermented milk product that is the result of fermentation with L. bulgaricus and S. thermophilus and its fluid shelters these probiotic microorganisms. 5 The therapeutic dose of yogurt has been reported to be around 10 6 -10 9 CFU of Lactobacilli and Bifidobacteria .…”

Efficacy and Safety of Saccharomyces boulardii for Acute Diarrhea

“…18,47,51 The overall quality was assessed and 4 studies were rated as "good" (low risk for bias), 43,45,48,50 13 studies rated as "fair," which were susceptible to some bias, 13,14,16,18,19,37,38,[40][41][42]44,49,51 and 5 studies rated as "poor" (high risk for bias). 17,39,46,47,52 Findings From Meta-analysis Seventeen studies (2102 participants) reported duration of diarrhea. 13,14,16,17,19,37,38,41,42,[44][45][46][47][48][49]51,52 The reduction in diarrhea duration ranged from 250.4 to 6.0 hours among included studies.…”

“…Briefly, only 1 study was adequate for all of the 4 methodological quality assessment parameters 43 and 1 was inadequate for all 4 parameters. 46 Eight studies were rated as adequate 14,16,19,37,43,45,48,51 and 4 were inadequate for generation of the allocation sequence, 17,39,46,47 and the method used for allocation sequence was unclear in 10 studies. 13,18,38,[40][41][42]44,49,50,52 Four studies were adequate, 14,43,45,48 14 studies were unclear, 13,16,18,19,37,38,[40][41][42]44,[49][50][51][52] and 4 studies were inadequate (as they used a method such as alternation.…”

“…13,18,38,[40][41][42]44,49,50,52 Four studies were adequate, 14,43,45,48 14 studies were unclear, 13,16,18,19,37,38,[40][41][42]44,[49][50][51][52] and 4 studies were inadequate (as they used a method such as alternation. 17,39,46,47 ) for allocation concealment. Six studies were adequate, 41,[43][44][45]48,50 12 studies were inadequate, 13,14,[16][17][18][19]37,39,46,47,49,52 and 4 studies were unclear for blinding.…”

“…17,39,46,47 ) for allocation concealment. Six studies were adequate, 41,[43][44][45]48,50 12 studies were inadequate, 13,14,[16][17][18][19]37,39,46,47,49,52 and 4 studies were unclear for blinding. 38,40,42,51 Loss to follow-up was adequate (#10%) in 12 studies 13,16,17,19,[37][38][39][40]43,47,49,50 ; 7 studies were considered inadequate 14,41,[44][45][46]48,52 and 3 studies unclear for loss to followup.…”