Efficacy and Safety of Saccharomyces Boulardii for Acute Diarrhea

Saccharomyces is a non-colonising yeast used for the last 70 plus years as a therapeutic agent for the relief and management of gastrointestinal distress. Whilst its community use as a by-product of lychee fermentation was well understood in indo china and other nations, in particular for the relief of choleric dysentery it was after Henri Boulard set up the French pharmaceutical company to exploit its potential that studies began. So the recent publication (July 2014) of a review paper in the well known journal Pediatrics is a helpful means of qualifying its use in the paediatric population[1]

Background and objective:

The efficacy of Saccharomyces boulardii for treatment of childhood diarrhoea remains unclear. Our objective was to systematically review data on the effect of S. boulardii on acute childhood diarrhoea.

Methods:

Our data sources included Medline, Embase, CINAHL, Scopus, and The Cochrane Library up to September 2013 without language restrictions. Randomised controlled trials and non-randomised trials that evaluated effectiveness of S. boulardii for treatment of acute diarrhoea in children were included. Two reviewers independently evaluated studies for eligibility and quality and extracted the data.

Results:

In total, 1248 articles were identified, of which 22 met the inclusion criteria. Pooling data from trials showed that S. boulardii significantly reduced the duration of diarrhoea (mean difference [MD], -19.7 hours; 95% confidence interval [CI], -26.05 to -13.34), stool frequency on day 2 (MD, -0.74; 95% CI, -1.38 to -0.10) and day 3 (MD, -1.24; 95% CI, -2.13 to -0.35), the risk for diarrhoea on day 3 (risk ratio [RR], 0.41; 95% CI, 0.27 to 0.60) and day 4 (RR, 0.38; 95% CI, 0.24 to 0.59) after intervention compared with control.

The studies included in this review were varied in the definition of diarrhoea, the termination of diarrhoea, inclusion and exclusion criteria, and their methodological quality.

Conclusion:

This review and meta-analysis show that S. boulardii is safe and has clear beneficial effects in children who have acute diarrhoea. However, additional studies using head-to-head comparisons are needed to define the best dosage of S. boulardii for diarrhoea with different causes.

Reference