Probiotic Relieves Diarrhea in Infants and Toddlers

By Will Boggs, MD

NEW YORK (Reuters Health) Jun 25 - The probiotic Escherichia coli Nissle 1917 is effective in treating diarrhea greater than 4 days' duration in infants and toddlers, according to a report in the June issue of The Pediatric Infectious Disease Journal.

"There is more and more evidence now for the effectiveness and safety of probiotic drugs," Dr. Jobst Henker from University Carl-Gustav-Carus, Dresden, Germany told Reuters Health. "Earlier data for probiotic foods or food supplements show an excellent safety record but sometimes lack firm data on efficacy."

Dr. Henker and colleagues note that the nonpathogenic E. coli strain Nissle 1917 (EcN) has been licensed in Europe for 90 years for treating bowel diseases. They investigated the response rate and time to response using EcN suspension or placebo in 151 infants and toddlers with diarrhea lasting more than 4 days.

More children treated with EcN than with placebo showed a response to treatment on day 7 (78.7% versus 59.2%, respectively), day 14 (93.3% versus 65.8%), and day 21 (98.7% versus 71.1%), the investigators report.

Diarrhea lasted a median 3.3 days less in children treated with EcN, the report indicates, and the number of stools decreased to three or less daily 2 days sooner in the EcN group than in the placebo group.

More children in the placebo group exhibited dehydration at the end of the study, the researchers note, and more children in the EcN group (97.0%) than in the placebo group (62.3%) improved from a "moderate" state of health to a "good" or "very good" state of health in the course of treatment.

There were no serious or severe adverse events, the investigators say, and only four events were judged to be possibly related to study medication. Parents' and investigators' ratings indicated that EcN was well tolerated by the children.

"Since there is one other successful EcN study by our group in acute children's diarrhea, we believe it is best to start probiotic therapy as early as possible," Dr. Henker said.

"We would like to address the subject of inflammatory bowel disease," Dr. Henker added. "Not only do excellent data exist for the use of EcN in ulcerative colitis remission maintenance in an adult population, but we were able to show similar results in children."

Pediatr Infect Dis J 2008;27:494-499.