Efficacy and safety of <i>Saccharomyces boulardii</i> in the treatment of acute gastroenteritis in the paediatric population: a systematic review

Morgambal Padayachee; Janicke Visser; Estelle Viljoen; Alfred Musekiwa; Renée Blaauw

Morgambal Padayachee Stellenbosch University
Janicke Visser Stellenbosch University
Estelle Viljoen Sefako Makgatho Health Sciences University
Alfred Musekiwa Stellenbosch University
Renée Blaauw Stellenbosch University

Keywords: gastroenteritis, paediatric, randomised controlled trial, Saccharomyces boulardii

Abstract

Background: Gastroenteritis (GE) remains the second major cause of death in the most vulnerable of the world’s populations. Potential treatments include the use of probiotics, with the yeast Saccharomyces boulardii being one such option.

Objectives: The primary objective was to assess the efficacy and safety of Saccharomyces boulardii in the treatment of acute GE in the paediatric population.

Method: Major electronic databases were searched from April 2014 to January 2015. Additional literature was obtained throughhand-searching and reviewing of reference lists of articles and other systematic reviews. Randomised controlled trials (RCTs) in a hospital setting, involving participants < 16 years were used as the data source. Two reviewers independently screened studies for eligibility, assessed study quality and performed data extraction. Review Manager 5 was used to analyse data and a random-effects model of meta-analysis was applied owing to heterogeneity.

Results: Ten of 190 articles were selected for final inclusion. A meta-analysis of five of the included studies showed that Saccharomyces boulardii compared with the control significantly shortened the duration of diarrhoea (in days) (MD –0.57, 95% CI –0.83 to –0.30, p < 0.0001), but there was no difference between groups regarding time to achieving formed stools. No adverse effects were reported. The GRADE tool assessed overall methodological quality as moderate.

Conclusion: Saccharomyces boulardii showed a potential benefit in treating acute GE in the paediatric patient. A dose of 250 mg 1–2 times per day for up to 5 days showed some benefit and appears safe. Larger, rigorous RCTs are needed to investigate the efficacy and safety of Saccharomyces boulardii in order to offer specific treatment guidelines.
Trial registration: CRD42014009913.

The full articles is available at https://doi.org/10.1080/16070658.2018.1449378

Author Biographies

Morgambal Padayachee, Stellenbosch University

Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Janicke Visser, Stellenbosch University

Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Estelle Viljoen, Sefako Makgatho Health Sciences University

Department of Human Nutrition and Dietetics, School of Health Care Sciences, Sefako Makgatho University, Pretoria, South Africa

Alfred Musekiwa, Stellenbosch University

Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Renée Blaauw, Stellenbosch University

Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa