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

From: Systematic review of probiotics for the treatment of community-acquired acute diarrhea in children

  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 [1217]
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, 1719]
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)
  1. *L. bulgaricus, L. acidophilus, Streptococcus thermophilus, B. bifidum
  2. ** L. acidophilus & Bifidobacteria infantis
  3. *** LGG, L. acidophilus, L. casei, L. plantarum, Bifidobacterium infantis
  4. ****L. bulgaricus & S. thermophilus