Acute Gastroenteritis Clinical Trial
An ORS with L. reuteri DSM 17938 and zinc is expected to reduce duration and severity of symptoms in infants and young children with acute gastroenteritis.
Oral rehydration solution is recommended for treatment and prevention of dehydration due to
acute gastroenteritis in infants and children (WHO/UNICEF, 2004; ESPGHAN / ESPID Guidelines,
2008). Acute diarrhoea may lead to zinc depletion in infants, and zinc supplementation is
recommended in infants and children with acute gastroenteritis living in developing
countries. In developed countries however, the studies on the efficacy of zinc
supplementation in children with acute gastroenteritis are few and conflicting.
Selected strains of probiotics, including L. reuteri ATCC 55730, have been shown in several
studies to reduce the duration and the severity of diarrhoea in children with acute
gastroenteritis and the effect is greater if the probiotics are given within 60 hours from
the onset of symptoms. Lactobacillus reuteri (L. reuteri) has been shown to reduce the
duration and severity of acute gastroenteritis in children aged 6-36 months. In these
studies L. reuteri was reported to have clinical effect on diarrhoea of both bacterial and
viral (rotavirus) origin. Furthermore, L. reuteri strain DSM 17938 has recently been shown
to reduce the duration of watery diarrhoea by 1.2 days among 6-36 mo old Italian children
with acute gastroenteritis treated in hospital.
The present study is a prospective, randomized, double blind, controlled study with parallel
groups. The planned investigation is designed to compare the efficacy of an ORS with L.
reuteri DSM 17938 and zinc to an ORS with similar osmolarity and content of salts but
without L. reuteri DSM 17938 and zinc, on the duration and severity of acute
gastroenteritis. 92 children aged 6-36 months seen at private pediatric clinics and/or at
the emergency clinics of the Athens Childrens Hospital "AGIA SOPHIA", and treated either as
outpatients or as inpatients will be recruited until the final sample size is reached.
Assuming a difference of 30% between groups in the primary outcome of prevalence of
diarrhoea on day 2, and estimating an attrition rate of approximately 15%, the final sample
size will be 92 subjects, or 46 subjects in each arm.
Data collection points will be on day 7 at the outpatient clinic of the Division of
Pediatric Gastroenterology & Nutrition of the First Department of Paediatrics, Athens
University Hospital.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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