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Pooled review (meta-analysis)

Pooled review of 33 trials in children on antibiotics: less diarrhea with probiotics

Guo and colleagues · The Cochrane database of systematic reviews · 2019

Original title: Probiotics for the prevention of pediatric antibiotic-associated diarrhea.

Under review. A person has not yet checked this summary against the paper. It is written from the PubMed abstract. Until a person checks it, search engines are asked not to list this page.

What the study found

Points to benefit

Diarrhea from antibiotics happened in 8% (259/3232) with probiotics and 19% (598/3120) with controls (RR 0.45, 95% CI 0.36 to 0.56). Doses of 5 billion CFUs a day or more worked better. No serious side effects were linked to probiotics.

The study at a glance

Type of study
Pooled review (meta-analysis)
Who or what was studied
33 studies, 6,352 people · children aged 0 to 18 taking antibiotics
What was tested
Probiotics (Bacillus, Bifidobacterium, Lactobacillus, Saccharomyces and others), alone or mixed, compared with placebo, other care or nothing, for 5 days to 12 weeks
What it measured
The question itself: gut symptoms such as bloating, pain and irregular bowels
Who has a stake
No stake declared
All authors declared no known competing interests.
Journal
The Cochrane database of systematic reviews, 2019
Source
PubMed record 31039287. This page is based on the abstract only.

How much this study counts

  • ✓Pools the results of 33 studies with 6,352 people.
  • •A pooled review is only as strong as the studies it pools.
  • ✓Measured the question itself: gut symptoms such as bloating, pain and irregular bowels.
  • ✓No competing interests declared.
  • •Summarized from the PubMed abstract only. The full paper may hold details the abstract leaves out.

✓ Strength– Limit• Note

These points come from fixed rules about the type of study, its size and length, what it measured, and who has a stake. Every study on Digestery gets the same rules.

Where this study sits

This paper is not on the ladder. It is a pooled review (meta-analysis), and reviews and opinion pieces discuss studies that are already counted on the steps below.

↑ Stronger evidence

  1. Trials in people: gut symptoms such as bloating and IBS

    9

    5 benefit, 2 mixed, 2 no difference

  2. Trials in people: other measures

    10

    4 benefit, 2 mixed, 4 no difference

  3. Trials in people: lab tests or safety

    0

    None among the papers we read.

  4. Population studies

    0

    None among the papers we read.

  5. Blood levels and genes

    0

    None among the papers we read.

↓ Weaker evidence

  • Points to benefit
  • Mixed
  • No difference
  • No direction
  • Points to harm

How it fits with the other research

The short answer to “Do probiotics improve gut health?”

Some strains may help some symptoms.

Confidence: low. Based on 28 on-topic papers.

Read the full answer
  • Quoted in “What we found”: In children taking antibiotics, diarrhea hit 8% with probiotics versus 19% in comparison groups, across 33 trials with 6352 children: less than half the risk.
  • Part of the finding “Children: diarrhea helped; constipation and belly pain unclear”.
  • Summed up in “What reviews found”: Pooled 33 trials with 6352 children taking antibiotics. Diarrhea occurred in 8% with probiotics vs 19% in control groups (RR 0.45), moderate certainty. Doses of 5 billion CFUs a day or more worked better.
  • Marked as a key paper in the research timeline: Cochrane review: probiotics cut antibiotic diarrhea in children.

Other reviews on this question

See all 28 studies on this question

How this page was made

Label

First read of the abstract
Claude Sonnet
Independent second read
Claude Haiku
Differences settled
The two reads agreed on every checked field. Claude Opus 5.5.
Headline
Claude Sonnet, from the checked study record. A script checked its numbers and wording.
Numbers
Checked against the abstract by a script
“How much this study counts”
Fixed rules, the same for every study
Source check by a person
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