OBJECTIVES

This study aimed to evaluate the comparative efficacy of Saccharomyces boulardii and Bacillus clausii in the treatment of acute diarrhea

A systematic search of MEDLINE, EBSCO, Clinical Key, the Cochrane Library, Academia, and Google Scholar was conducted to identify clinical trials using Saccharomyces boulardii and Bacillus clausii as interventions. The primary outcome measure was the duration of diarrhea. Risk of bias was assessed using the CEBM Critical Appraisal tool and the Cochrane Collaboration tool. Data were analyzed using RevMan 5.4 software.

Four studies involving 411 participants were included in the systematic review and meta-analysis. All studies demonstrated a weighted mean decrease in the duration of diarrhea, ranging from 4.70 to 25.20 hours, favoring Saccharomyces boulardii. The pooled analysis revealed a significant reduction of 24.98 hours in the duration of diarrhea, favoring Saccharomyces boulardii (p < 0.0001).

A systematic review and meta-analysis of four clinical trials showed that Saccharomyces boulardii is more effective than Bacilus clausii in reducing the duration of diarrhea among patients with acute diarrhea. These findings support the use of Saccharomyces boulardii as a preferred probiotic intervention for the treatment of acute diarrhea.

INTRODUCTION: Probiotics such as Saccharomyces boulardii are now advocated for the treatment of diarrhea. The objective of this systematic review and meta-analysis was to determine the effectiveness of Saccharomyces boulardii in the treatment of diarrhea. METHODS: MEDLINE, EBSCO, Clinical Key, and the Cochrane Library were searched for clinical trials which used Saccharomyces boulardii as primary or adjuvant treatment for diarrhea. Outcomes included were treatment success in the form of cessation of diarrhea, decrease in the duration of diarrhea, decrease in hospital days, and improvement of dehydration. The Centre for Evidence-Based Medicine Critical Appraisal tool together with the Cochrane Collaboration tool was used to assess the risk of bias, RevMan 5.4 for encoding, and the Mantel-Haenszel method for analysis to compute a pooled result. RESULTS: Eleven clinical trials involving 1,541 participants were included in the systematic review and meta-analysis. Seven studies showed a non-significant overall decrease in the duration of diarrhea of 1.65 days (p = 0.25), five studies showed an overall significant beneficial response (RR = 1.68, p < 0.001) in the cessation of diarrhea. There was a statistically significant mean decrease (1.01 days, p < 0.001) in duration of hospitalization; and a statistically significant decrease (0.18 days or 4.32 hours, p = 0.04) in the duration of vomiting. CONCLUSION A systematic review and meta-analysis of 11 clinical trials favors the use of Saccharomyces boulardii in the treatment of diarrhea in terms of cessation of diarrhea, decrease in the duration of hospitalization and duration of vomiting.
Saccharomyces boulardii ; Probiotics ; Diarrhea