International guidelines and practice guidelines for the management of infectious diarrhea contain recommendations for the prescription of probiotics as a complex therapy. According to several meta-analyzes based on 20 studies and 2 751 participants, the use of probiotics for infectious diarrhea contributes to:
- Decrease of the risk of the development of diarrhea with a duration of more than 4 days
- Decrease of the duration of diarrhea by an average of 25 hours
- Decrease of the frequency of stool on the second day of diarrhea
This summary of evidence is provided to justify the recommendations of the prescription of probiotics for the prevention and treatment of infectious diarrhea in children and adults in Practice Guidelines on the Diagnosis and Treatment of Infectious Diarrhea of the Infectious Diseases Society of America (IDSA), 2017. 1
The World Health Organization (WHO) defines diarrhea as loose or watery stool that occurs three or more times per day, or more often than usual for a particular person. It is usually a symptom of a gastrointestinal infection that can be caused by a wide variety of bacteria, viruses and parasites. The infection is transmitted through contaminated food products or drinking water, or from person to person as a result of poor hygiene.
According to the WHO’s data, diarrhea is one of the leading causes of death in children under the age of five years around the world. More than one of ten children’s deaths - about 800 000 annually - are due to diarrhea.2
Norovirus and Salmonella enterica are the leading putative foodborne pathogens. Among children under the age of 5 years, rotavirus was the most common pathogen in the United States prior to the introduction of a rotavirus vaccine. The most common bacterial pathogens in this age group are Salmonella enterica (42%), Campylobacter (28%), Shigella (21%), Yersinia (5%) and E. coli O157 (3%). 2
Probiotics contribute to the restoration of normal microflora due to competitive antagonism with pathogenic microorganisms, the production of special toxic antipathogens and an immunomodulatory action.
1. Shane AL, Mody RK, Crump JA, Tarr PI, Steiner TS, Kotloff K, Langley JM, Wanke C, Warren CA, Cheng AC, Cantey J, Pickering LK. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017 Nov
2. World Health Organization (WHO). Diarrhoea. Available at: https://www.who.int/topics/diarrhoea/ru/