Table 1 Asian experts’ recommendations on the use of probiotics and Bacillus clausii (O/C, SIN, N/R, T) in the management of pediatric diarrhea
Section 1: Probiotics as adjunct treatment in diarrhea | |
1. Acute viral diarrhea is the best-established indication for probiotics administration in childhood. Probiotics have a promising role in the treatment of acute viral diarrhea. | |
2. Evidence has accumulated on the efficacy of probiotics in reducing the duration and severity of acute diarrhea in children. | |
3. Probiotics administration may be considered as an adjunct therapy for the prevention of antibiotic-associated diarrhea. | |
4. Probiotics significantly reduce the risk of Clostridium difficile-associated diarrhea in adults and children. | |
Section 2: Bacillus clausii (O/C, SIN, N/R, T) in acute diarrhea | |
1. Bacillus clausii (O/C, N/R, SIN, TETRA) may be considered as adjunct to ORS and zinc in acute childhood diarrhea. | |
2. Bacillus clausii has been found to be safe in clinical trials conducted in Asian children with acute diarrhea. | |
3. Strain-specific poly-antibiotic–resistant Bacillus clausii is efficacious in reducing the duration and frequency of diarrhea, hospital stay, and financial burden. | |
Section 3: Bacillus clausii (O/C, SIN, N/R, T) in chronic diarrhea 1. There is very limited evidence supporting the use of probiotics for the management of chronic/persistent diarrhea in children. | |
Section 4: Bacillus clausii (O/C, SIN, N/R, T) in antibiotic-associated diarrhea | |
1. Probiotics administration may be considered for the prevention of antibiotic-associated diarrhea (AAD). | |
2. Physicians should evaluate the risk factors for the occurrence of AAD or Clostridium difficile-associated diarrhea, such as the class of antibiotics, duration of antibiotic treatment, need for hospitalization, age, comorbidities, and previous episodes of AAD or C. difficile-associated diarrhea when considering probiotics for prevention of AAD in children. | |
3. Bacillus clausii can be used as co-adjuvant therapy for Helicobacter pylori eradication. |