Methodological quality of clinical practice guidelines on probiotics in acute gastroenteritis in children using the appraisal of guidelines for research & evaluation II instrument (AGREE II)

Abstract

Acute Gastroenteritis (AGE) is one of the diseases that most frequently affects paediatric population. Successful treatment in AGE has been mainly based on prevention and treatment of its complications; however every day, we find more publications on the use of adjuvants to decrease its duration. Some probiotics report benefits, particularly in terms of reducing duration of the episode or stool frequency. We look for clinical guidelines that recommend their use in AGE in children and we assessed their methodology quality by the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument. All of the CPG consider that the administration of Lactobacillus rhamnosus GG and Saccharomyces boulardii should be considered in the management of children with AGE as an adjunct to rehydration therapy with different levels of evidence. Four CPG had one rating higher than 60% in 4 or more domains and one in only one domain. Only a CPG was greater than 60% in all domains. Four had an overall score greater than or equal to 5 and were 'recommended', and one with modifications, according to the instrument AGREE II. In conclusion: the selected GPC have good methodological quality, but are not specific to probiotics. Despite, they should be spread for better decision making.