Effectiveness and Safety of Saccharomyces Boulardii for the Treatment of Acute Gastroenteritis in the Pediatric Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Objective. To explore the efficacy and safety of Saccharomyces boulardii for the treatment of acute gastroenteritis in children aged under 5. Methods. Two independent researchers retrieved literature from PubMed, OVID, Embase, ScienceDirect, and other databases, followed by extracting indicators of the primary endpoints. Cochrane Q test and $I^2$ statistics were used to evaluate interstudy heterogeneity. The relative risk (RR) and mean difference (MD) of related indicators were calculated and combined using the random- or fixed-effect model, as appropriate. Furthermore, the funnel plot and Egger’s test were used to evaluate the publication bias. A two-sided $P<0.05$ denoted statistical significance. Results. 10 articles were included in this meta-analysis, with a total of 1282 children having acute gastroenteritis. The use of Saccharomyces boulardii in children with acute gastroenteritis could effectively shorten diarrhea duration ( $\text{MD}=19.70$ , 95% CI: -24.87, 14.52) and reduce the length of hospital stay ( $\text{MD}=-0.91$ , 95% CI: -1.28, -0.54). Compared with the control group, the RR of continued diarrhea was significantly lower in the treatment group after 1 day treatment ( $\text{RR}=-0.31$ , 95% CI: 0.59, 0.03) and 3 days treatment ( $\text{RR}=0.52$ , 95% CI: 0.41, 0.66). In addition, treatment with Saccharomyces boulardii reduced the average number of diarrhea after 3 days of treatment by about 1.03 ( $\text{MD}=-1.03$ , 95% CI: -1.53, -0.53). There were no adverse drug reactions in both groups. Conclusion. The use of probiotic Saccharomyces boulardii can significantly improve the symptoms of diarrhea in children with acute gastroenteritis and reduce the duration of diarrhea symptoms and the time of hospitalization. Meanwhile, the RR of continued diarrhea in children after 1 and 3 days of Saccharomyces boulardii treatment and the frequency of diarrhea after 3 days of Saccharomyces boulardii treatment were decreased. It is also safe and does not increase the incidence of adverse drug reactions.