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Date of Award

Spring 2021

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Kevin Basile, MD, PT

Abstract

Introduction: Diarrhea, defined as 3 or more loose watery stools per day, ranges from a nuisance in the developing world to a life-threatening condition in developing countries. Diarrhea is the second leading cause of death of children under 5 worldwide. Standard treatment is administration of an oral rehydration solution (ORS), with zinc supplementation added to this treatment in developing countries. Recent studies propose potential for the addition of probiotic supplementation to this established standard. This paper examines the efficacy of probiotic supplementation in reducing diarrhea duration when compared to traditional treatment of oral rehydration in healthy pediatric patients (under 5 years old, with no chronic conditions) with acute diarrhea.

Methods: In November 2019, the PubMed and ScienceDirect databases were utilized to conduct a literature search. A total of 6 studies were ultimately chosen based on their relevancy to the research question as well as similarities in study design, exclusion criteria, and outcome measures.

Results: Reviews of the studies reveal conflicting results. 4 of the 6 studies suggest probiotic supplementation reduces diarrhea duration, while the 2 largest studies recommend against this treatment. The studies had similarities in demographics, study design, and outcome measures. Large variations in geographic location, treatment type, and treatment dosage are found across the research.

Discussion: Variations in treatments used in each study, especially the use of many different probiotic strains, makes comparison difficult. All studies found minimal difference in adverse events between control and treatment groups, indicating probiotics are likely safe in pediatric populations. Despite smaller studies presenting promising research in favor of probiotic supplementation, no evidence provided by larger or more strictly designed studies suggests probiotics provide any benefit in this context. Evidence is lacking to recommend use of probiotics in pediatric patients suffering from acute diarrhea.

Additional Files

Probiotic Supplementation in Acute Pediatric Diarrhea.pdf (2308 kB)
Presentation PDF

Patterson References.pdf (82 kB)
References

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Probiotic Supplementation in Acute Pediatric Diarrhea

Introduction: Diarrhea, defined as 3 or more loose watery stools per day, ranges from a nuisance in the developing world to a life-threatening condition in developing countries. Diarrhea is the second leading cause of death of children under 5 worldwide. Standard treatment is administration of an oral rehydration solution (ORS), with zinc supplementation added to this treatment in developing countries. Recent studies propose potential for the addition of probiotic supplementation to this established standard. This paper examines the efficacy of probiotic supplementation in reducing diarrhea duration when compared to traditional treatment of oral rehydration in healthy pediatric patients (under 5 years old, with no chronic conditions) with acute diarrhea.

Methods: In November 2019, the PubMed and ScienceDirect databases were utilized to conduct a literature search. A total of 6 studies were ultimately chosen based on their relevancy to the research question as well as similarities in study design, exclusion criteria, and outcome measures.

Results: Reviews of the studies reveal conflicting results. 4 of the 6 studies suggest probiotic supplementation reduces diarrhea duration, while the 2 largest studies recommend against this treatment. The studies had similarities in demographics, study design, and outcome measures. Large variations in geographic location, treatment type, and treatment dosage are found across the research.

Discussion: Variations in treatments used in each study, especially the use of many different probiotic strains, makes comparison difficult. All studies found minimal difference in adverse events between control and treatment groups, indicating probiotics are likely safe in pediatric populations. Despite smaller studies presenting promising research in favor of probiotic supplementation, no evidence provided by larger or more strictly designed studies suggests probiotics provide any benefit in this context. Evidence is lacking to recommend use of probiotics in pediatric patients suffering from acute diarrhea.