Abu Syed Md. Mosaddek
Objective: The study aimed to assess the efficacy of probiotics in the context of acute watery Diarrhoea and their effects on serum immunoglobulin in children.
Methods: Prospective clinical trial in children aged one month to 12 years hospitalized with acute watery Diarrhoea in Uttara Adhunik Medical College, and allocated to receive probiotics, antibiotics, or probiotics + antibiotics for 30 days in accordance with the standard treatment protocol of Diarrhoea. Clinical outcome measurements included duration of Diarrhoea and treatment adverse events. Stool culture and blood immunoglobulin were analyzed on days 0 and 30.
Results: 166 enrolled children were divided into three groups: Group A (probiotics), Group B (antibiotics) and Group C (probiotics + antibiotics) with 98 participants returning for a follow-up visit on day 30. All groups were comparable in their baseline characteristics. Causative organisms of Diarrhoea among final participants (N=98) were Rotavirus (69.4%), E. Coli (67.4%), multiple organisms (2 or more) (45.9%), Campylobacter (34.7%), Vibrio cholerae (20.4%), Salmonella (10.2%), Shigella (9.2%), and Klebsiella (1.0%). Fastest recovery occurred in Group A (3.03 ± 0.76 days; Group C: 3.80 ± 1.10 days; Group B: 4.11 ± 1.48 days; p=0.001). At follow-up, administration of probiotics was associated with presence of commensal Lactobacillus and Bifidobacterium in stool.
Conclusion: Inclusion of probiotics for treatment of acute watery Diarrhoea in children is effective, safe and results in shorter duration of Diarrhoea and faster discharge from hospital. Probiotics may provide future alternative prevention and treatment strategies in childhood Diarrhoeal diseases in Bangladesh.