Saccharomyces boulardii CNCM I-745 reduces the duration of diarrhoea, length of emergency care and hospital stay in children with acute diarrhoea

Abstract

Evidence from the literature has shown that Saccharomyces boulardii provides a clinically significant benefit in the treatment of acute infectious diarrhoea in children. In this multicentre, randomised, prospective, controlled, single blind clinical trial performed in children with acute watery diarrhoea, we aimed to evaluate the impact of S. boulardii CNCM I-745 in hospitalised children, in children requiring emergency care unit (ECU) stay and in outpatient settings. The primary endpoint was the duration of diarrhoea (in hours). Secondary outcome measures were duration of hospitalisation and diarrhoea at the 3(rd) day of intervention. In the whole study group (363 children), the duration of diarrhoea was approximately 24 h shorter in the S. boulardii group (75.4±33.1 vs 99.8±32.5 h, P<0.001). The effect of S. boulardii (diarrhoea-free children) was observed starting at 48 h. After 72 h, only 27.3% of the children receiving probiotic still had watery diarrhoea, in contrast to 48.5% in the control group (P<0.001). The duration of diarrhoea was significantly reduced in the probiotic group in hospital, ECU and outpatient settings (P<0.001, P<0.01 and P<0.001, respectively). The percentage of diarrhoea-free children was significantly larger after 48 and 72 h in all settings. The mean length of hospital stay was shorter with more than 36 h difference in the S. boulardii group (4.60±1.72 vs 6.12±1.71 days, P<0.001). The mean length of ECU stay was shorter with more than 19 h difference in the probiotic group (1.20±0.4 vs 2.0±0.3 days, P<0.001). No adverse effects related to the probiotic were noted. Because treatment can shorten the duration of diarrhoea and reduce the length of ECU and hospital stay, there is likely a social and economic benefit of S. boulardii CNCM I-745 in adjunction to oral rehydration solution in acute infectious gastroenteritis in children.

Systematic review with meta‐analysis: Saccharomyces boulardii for treating acute gastroenteritis in children—a 2020 update

“…Ultimately, 29 RCTs that randomised 4217 participants (2152 in the experimental group and 2065 in the control group) were included . .…”

Time Series Analysis of the Microbiota of Children Suffering From Acute Infectious Diarrhea and Their Recovery After Treatment

“…S. boulardii can reduce the duration of diarrhea by approximately 1 day, shorten the initial phase of watery stools, and decrease the length of hospital stay (Dinleyici et al, 2012 ). Our recent study in a clinical trial with probiotics in acute gastroenteritis (PROBAGE Study), which is a multicenter, randomized, prospective, controlled, single-blind clinical trial, showed that S. boulardii CNCM I-745 reduced the duration of diarrhea in both in- and out-patient settings, as well as reduced the length of emergency care unit and hospital stay among children below 5 years of age with acute infectious diarrhea (Dinleyici et al, 2015 ). The probiotic effect started to be observed at 48 h of intervention, and major beneficial effects were seen at 72 h. A recent meta-analysis showed that in 9 out of 11 clinical trials, S. boulardii was beneficial in children with acute infectious diarrhea, as it significantly reduced the duration of their acute infectious diarrhea by approximately 24 h compared with the controls (Dinleyici et al, 2012 ).…”

A Multicenter, Randomized, Double-blind, Placebo-controlled Trial of Saccharomyces boulardii in Infants and Children With Acute Diarrhea

“…Faster remission in the group receiving the probiotic is consistent with previous findings of several authors reporting an approximately 1 day faster recovery from diarrhea with S. boulardii . 14 – 18 After 3 days of treatment, more children in the probiotic group had recovered from diarrhea than those in the placebo group. Consistently, Correa et al reported a lower frequency of patients with diarrhea within 3 days from randomization in the group supplemented with S. boulardii (RR 0.54, 95% CI: 0.38–0.77, P < 0.001).…”