Efficacy of Lactobacillus reuteri DSM 17938 in Thai children with acute gastroenteritis and normal or mild dehydration in an outpatient setting: a randomized controlled trial

Abstract Lactobacillus reuteri DSM 17938 (L. reuteri) has been recommended for treating acute diarrhoea; however, literature data about its efficacy are scarce and controversial. This study investigated the effectiveness of L. reuteri supplementation on the treatment outcome of children with acute diarrhoea. A randomized double-blind controlled trial was conducted in children with acute diarrhoea who attended the outpatient clinic of Srinakharinwirot University Hospital, Thailand. Eligible children were randomly allocated to receive either L. reuteri 1 × 108 colony-forming units or a placebo for 5 days. The primary outcome was the time diarrhoea was resolved. Of the 48 participants (23 in L. reuteri and 25 in the placebo group), 29 (60.4%) were male and the mean age (range) was 12.3 months (1–26 months). The median time for diarrhoea to be resolved was significantly shorter in the L. reuteri group compared to the control (48 and 60 h, respectively, P-value = .042). The percentage of participants who recovered within 48 h was significantly higher in the L. reuteri group (65.2%) compared to the control group (36.0%) [relative risk (RR) 3.33, 95% confidence interval (CI) 1.02–10.89, P-value = .043]. The percentage of participants who recovered from diarrhoea within 72 h was 87.0% and 60%, respectively, [RR 4.44, 95% CI 1.04–19.0, P-value = .036]. No persistent diarrhoea or severe adverse effects were observed in both groups.The use of L. reuteri DSM 17938 as an adjunct therapy led to a significantly shorter duration of diarrhoea in children with acute diarrhoea.