A randomized trial evaluating virus-specific effects of a combination probiotic in children with acute gastroenteritis

Stephen B. Freedman (), Jianling Xie, Alberto Nettel-Aguirre, Xiao-Li Pang, Linda Chui, Sarah Williamson-Urquhart, David Schnadower, Suzanne Schuh, Philip M. Sherman, Bonita E. Lee, Serge Gouin, Ken J. Farion, Naveen Poonai, Katrina F. Hurley, Yuanyuan Qiu, Binal Ghandi, Colin Lloyd and Yaron Finkelstein
Additional contact information
Stephen B. Freedman: University of Calgary
Jianling Xie: University of Calgary
Alberto Nettel-Aguirre: University of Calgary
Xiao-Li Pang: University of Alberta, 116 St & 85 Ave.
Linda Chui: University of Alberta, 116 St & 85 Ave.
Sarah Williamson-Urquhart: University of Calgary
David Schnadower: University of Cincinnati, 3333 Burnet Ave
Suzanne Schuh: University of Toronto, 555 University Avenue
Philip M. Sherman: University of Toronto, 555 University Avenue
Bonita E. Lee: University of Alberta, 116 St & 85 Ave.
Serge Gouin: Université de Montréal, 3175 Chemin de la Côte-Sainte-Catherine
Ken J. Farion: University of Ottawa, 401 Smyth Rd
Naveen Poonai: University of Western Ontario, 800 Commissioners Road E
Katrina F. Hurley: Dalhousie University, 5980 University Avenue, PO Box 9700
Yuanyuan Qiu: University of Alberta, 116 St & 85 Ave.
Binal Ghandi: University of Alberta, 116 St & 85 Ave.
Colin Lloyd: University of Alberta, 116 St & 85 Ave.
Yaron Finkelstein: University of Toronto, 555 University Avenue

Nature Communications, 2020, vol. 11, issue 1, 1-9

Abstract: Abstract Gastroenteritis accounts for nearly 500,000 deaths in children younger than 5 years annually. Although probiotics have been touted as having the potential to expedite diarrhea resolution, recent clinical trials question their effectiveness. A potential explanation is a shift in pathogens following the introduction of a rotavirus vaccine. Here, we report the results of a multi-center, double-blind trial of 816 children with acute gastroenteritis who completed follow-up and provided multiple stool specimens. Participants were randomized to receive a probiotic containing Lactobacillus rhamnosus and Lactobacillus helveticus or placebo. We report no virus-specific beneficial effects attributable to the probiotic, either in reducing clinical symptoms or viral nucleic acid clearance from stool specimens collected up to 28 days following enrollment. We provide pathophysiological and microbiologic evidence to support the clinical findings and conclude that our data do not support routine probiotic administration to children with acute gastroenteritis, regardless of the infecting virus.

Date: 2020
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DOI: 10.1038/s41467-020-16308-3

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