Table 2

Quality of evidence for treatment of diarrhea with probiotics for diarrhea duration and stool frequency on day 2

Quality assessment

Summary of findings


Directness


No. of studies (study arms)

Design

Limitations

Consistency

Generalizability to population of interest

Generalizability to intervention of interest

Average percent difference (95% CI)


Diarrhea duration

Various probiotics: low [12-17]

6(10)

RCT

Different doses/day; variable treatment duration; not double blinded, small n, placebo not described (-0.5)

8/10 arms in the positive direction; 4/10 results statistically significant (-0.5)

Algeria, Italy, Brazil, Belgium, India, Taiwan (-0.5)

Mixtures prevent analysis of individual effect sizes, not enough data to make a statement about each probiotic strain (-0.5)

-14.0 (-24.2 – -3.8%)

Lactobacillus rhamnosus GG: moderate [13,14,16]

3(3)

RCT

Different doses/day; variable treatment duration; not double blinded (-0.5)

3/3 studies in the positive direction; 1/3 study results statistically significant

Italy, Brazil, India

Generalizable

-16.0 (-53.9 – 22.0%)


Stool frequency (Day 2)

Various probiotics: moderate/low [13,15,17-19]

5(9)

RCT

Not double blinded, small n, placebo not described (-0.5)

5/9 arms in the positive direction; 4/9 results statistically significant (-0.5)

Italy, Iran, Mexico, Taiwan, Belgium

Mixtures prevent analysis of individual effect sizes, not enough data to make a statement about each probiotic strain (-0.5)

-13.1 (-25.3 – -0.8%)


Diarrhea duration (study arms): LGG (3), S. boulardii (1), Bacillus clausii (1), Enterococcus faecium (1), Mix A*(1), Mix B**(1), Mix C***(1), Mix D****(1)

Stool frequency (study arms): LGG (1), S. boulardii (2), Bacillus clausii (1), Enterococcus faecium (1), L. acidophilus (1), Mix A*(1), Mix B**(1), Mix C***(1)


*L. bulgaricus, L. acidophilus, Streptococcus thermophilus, B. bifidum

** L. acidophilus & Bifidobacteria infantis

*** LGG, L. acidophilus, L. casei, L. plantarum, Bifidobacterium infantis

****L. bulgaricus & S. thermophilus

Applegate et al. BMC Public Health 2013 13(Suppl 3):S16   doi:10.1186/1471-2458-13-S3-S16

Open Data