Lactobacillus rhamnosus GG in Paediatric Acute Diarrhoea: A Clinical Perspective and Systematic Review of Clinical Studies Published in the Last Decade

  • Dharmeshkumar B Kheni Department of Pharmacology, Kadi Sarva Vishwavidyalaya, Gandhinagar, Gujarat, India.
  • Varun P Sureja Department of Pharmacology, Kadi Sarva Vishwavidyalaya, Gandhinagar, Gujarat, India.
  • Shrikalp S Deshpande Department of Pharmacology, K B Institute of Pharmaceutical Education and Research, Gandhinagar, India.
  • Vishal P Dubey Department of Scientific and Medical Affairs, Sundyota Numandis Probioceuticals Pvt Ltd, Ahmedabad, Gujarat, India.
  • Jignesh J Kansagra Department of Scientific and Medical Affairs, Sundyota Numandis Probioceuticals Pvt Ltd, Ahmedabad, Gujarat, India.
Keywords: Lactobacillus rhamnosus GG, Diarrhoea, Children, Infant, Systematic Review

Abstract

Gut dysbiosis is one of the risk factors to cause acute diarrhoea in children. Lactobacillus rhamnosus GG (L. rhamnosus GG) is one of the most studied probiotic strains and its efficacy in acute diarrhoea is validated in various clinical studies. The current systematic review aimed to evaluate the efficacy of L. rhamnosus GG in paediatric acute diarrhoea by using the clinical studies published in the last decade (till September 2023). Articles were retrieved from five online databases and screened as per the pre-designed protocol. The quality of the studies that qualified was assessed using the Physiotherapy Evidence Database (PEDro) scale. The studies were critically reviewed for the efficacy of L. rhamnosus GG in various parameters related to paediatric acute diarrhoea conditions. After screening 1758 articles for eligibility, six studies were considered in the current study. Every study that was included was of a moderate-to-good quality. L. rhamnosus GG supplementation in combination with standard therapy shows better improvement in diarrhoea duration, stool consistency, stool frequency, and duration of hospital stay as compared to standard therapy alone supplementation. The study’s findings are consistent with the results of previous studies and suggest that the supplementation of Lactobacillus rhamnosus GG is an effective adjunct therapy in paediatric acute diarrhoea conditions.

How to cite this article:
Kheni D B, Sureja V P, Deshpande S S, Dubey V P, Kansagra J J. Lactobacillus rhamnosus GG in Paediatric Acute Diarrhoea: A Clinical Perspective and Systematic Review of Clinical Studies Published in the Last Decade. Chettinad Health City Med J. 2024;13(4):135-145.

DOI: https://doi.org/10.24321/2278.2044.202470

References

Mahyar A, Ayazi P, Rad MS, Dalirani R, Javadi A, Esmaeily S. The correlation between vitamin D and bacterial diarrhea in children. Arch Pediatr Infect Dis. 2019;7(2):e84382. [Google Scholar]

Hartman RM, Cohen AL, Antoni S, Mwenda J, Weldegebriel G, Biey J, Shaba K, de Oilveira L, Rey G, Ortiz C, Tereza M, Fahmy K, Ghoniem A, Ashmony H, Videbaek D, Singh S, Tondo E, Sharifuzzaman M, Liyanage J, Batmunkh N, Grabovac V, Logronio J, Serhan F, Nakamura T. Risk factors for mortality among children younger than age 5 years with severe diarrhea in lowand middle-income countries: findings from the World Health Organization-coordinated Global Rotavirus and Pediatric Diarrhea Surveillance Networks. Clin Infect Dis. 2023;76(3):e1047-53. [PubMed] [Google Scholar]

Modgil V, Chaudhary P, Bharti B, Mahindroo J, Yousuf M, Koundal M, Mohan B, Taneja N. Prevalence, virulence gene profiling, and characterization of enteroaggregative Escherichia coli from children with acute diarrhea, asymptomatic nourished, and malnourished children younger than 5 years of age in India. J Pediatr. 2021;234:106-14.e5. [PubMed] [Google Scholar]

Nemeth V, Pfleghaar N. Diarrhea. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Sep 19]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448082/ [PubMed]

Najafi A, Najafi S, Vahdat K, Kargar M, Javdani N. Importance of viral pathogens in children with acute gastroenteritis in the south of Iran. Ann Saudi Med. 2013;33(2):124-9. [PubMed] [Google Scholar]

Ansari S, Sherchand JB, Parajuli K, Mishra SK, Dahal RK, Shrestha S, Tandulkar S, Pokhrel BM. Bacterial etiology of acute diarrhea in children under five years of age. J Nepal Health Res Counc. 2012;10(22):218-23. [PubMed] [Google Scholar]

Getahun W, Adane M. Prevalence of acute diarrhea and water, sanitation, and hygiene (WASH) associated factors among children under five in Woldia Town, Amhara Region, northeastern Ethiopia. BMC Pediatr. 2021;21(1):227. [PubMed] [Google Scholar]

Plourde PJ. Travellers’ diarrhea in children. Paediatr Child Health. 2003;8(2):99-103. [PubMed] [Google Scholar]

Mohammed J, Shiferaw A, Zeleke A, Eshetu Y, Gebeyehu Z, Ayehu A, Adem Y. Prevalence and associated risk factors of intestinal parasites among diarrheic underfive children attending Bahir Dar and Han Health Centers, northwest Ethiopia: a cross-sectional study. J Parasitol Res. 2022;2022:7066529. [PubMed] [Google Scholar]

Chen MH, Deng SH, Wang MH, Yan XK. Clinical characteristics and influencing factors of infectious diarrhea in preschool children: an observational study. Medicine (Baltimore). 2023;102(17):e33645. [PubMed] [Google Scholar]

D’Argenio V, Salvatore F. The role of the gut microbiome in the healthy adult status. Clin Chim Acta. 2015;451(Pt A):97-102. [PubMed] [Google Scholar]

Krajmalnik-Brown R, Ilhan ZE, Kang DW, DiBaise JK. Effects of gut microbes on nutrient absorption and energy regulation. Nutr Clin Pract. 2012;27(2):201-14. [PubMed] [Google Scholar]

Sanidad KZ, Zeng MY. Neonatal gut microbiome and immunity. Curr Opin Microbiol. 2020;56:30-7. [PubMed] [Google Scholar]

Thursby E, Juge N. Introduction to the human gut microbiota. Biochem J. 2017;474(11):1823-36.[PubMed] [Google Scholar]

Bidell MR, Hobbs AL, Lodise TP. Gut microbiome health and dysbiosis: a clinical primer. Pharmacotherapy. 2022;42(11):849-57. [PubMed] [Google Scholar]

Gebrayel P, Nicco C, Al Khodor S, Bilinski J, Caselli E, Comelli EM, Egert M, Giaronni C, Karpinski TM, Loniewski I, Mulak A, Reygner J, Samczuk P, Serino M, Sikora M, Terranegra A, Ufnal M, Villeger R, Pichon C, Konturek P, Edeas M. Microbiota medicine: towards clinical revolution. J Transl Med. 2022;20(1):111. [PubMed] [Google Scholar]

Dixit K, Chaudhari D, Dhotre D, Shouche Y, Saroj S. Restoration of dysbiotic human gut microbiome for homeostasis. Life Sci. 2021;278:119622. [PubMed] [Google Scholar]

Xiao Q, Chen B, Zhu Z, Yang T, Tao E, Hu C, Zheng W, Tang W, Shu X, Jiang M. Alterations in the fecal microbiota composition in pediatric acute diarrhea: a cross-sectional and comparative study of viral and bacterial enteritis. Infect Drug Resist. 2023;16:5473-83. [PubMed] [Google Scholar]

Fijan S. Probiotics and their antimicrobial effect. Microorganisms. 2023;11(2):528. [PubMed] [Google Scholar]

Stavropoulou E, Bezirtzoglou E. Probiotics in medicine: a long debate. Front Immunol. 2020;11:2192. [PubMed] [Google Scholar]

Fijan S. Microorganisms with claimed probiotic properties: an overview of recent literature. Int J Environ Res Public Health. 2014;11(5):4745-67. [PubMed] [Google Scholar]

Gorbach S, Doron S, Magro F. Lactobacillus rhamnosus GG. In: Floch MH, Ringel Y, Walker AW, editors. The microbiota in gastrointestinal pathophysiology: implications for human health, prebiotics, probiotics, and dysbiosis. Elsevier Inc.; 2017. p. 79-88. [Google Scholar]

Yan F, Polk DB. Lactobacillus rhamnosus GG: an updated strategy to use microbial products to promote health. Funct Food Rev. 2012;4(2):77-84. [PubMed] [Google Scholar]

Li YT, Xu H, Ye JZ, Wu WR, Shi D, Fang DQ, Liu Y, Li LJ. Efficacy of Lactobacillus rhamnosus GG in treatment of acute pediatric diarrhea: a systematic review with metaanalysis. World J Gastroenterol. 2019;25(33):4999-5016. [PubMed] [Google Scholar]

Published
2024-12-31