Meta-analysis: Smectite in the treatment of acute infectious diarrhoea in children.

Abstract:

BACKGROUND:Although not currently recommended, dioctahedral smectite (smectite) is commonly used to treat acute infectious diarrhoea in many countries. AIM:To evaluate systematically the effectiveness of smectite in treating acute infectious diarrhoea in children. METHODS:Using medical subject headings and free-language terms, the following electronic databases were searched for studies relevant to acute infectious diarrhoea and smectite: MEDLINE, EMBASE, CINAHL and The Cochrane Library; additional references were obtained from reviewed articles. Only randomized-controlled trials were included. RESULTS:Nine randomized-controlled trials (1238 participants) met the inclusion criteria. Combined data from six randomized-controlled trials showed that smectite significantly reduced the duration of diarrhoea compared with placebo. The pooled weighted mean difference was (-22.7 h, 95% CI: -24.8 to -20.6) with a fixed model and remained significant in a random effect model (-24.4 h, 95% CI: -29.8 to -19.1). The chance of cure on intervention day 3 was significantly increased in the smectite vs. the control group (RR 1.64, 95% CI: 1.36-1.98; number needed to treat 4, 95% CI: 3-5). Adverse effects were similar in both groups. CONCLUSIONS:Smectite may be a useful adjunct to rehydration therapy in treating acute paediatric gastroenteritis. However, the results of this meta-analysis should be interpreted with caution as most of the included studies had important limitations. Cost-effectiveness analyses should be undertaken before routine pharmacological therapy with smectite is recommended.

journal_name

Aliment Pharmacol Ther

authors

Szajewska H,Dziechciarz P,Mrukowicz J

doi

10.1111/j.1365-2036.2006.02760.x

subject

Has Abstract

pub_date

2006-01-15 00:00:00

pages

217-27

issue

2

eissn

0269-2813

issn

1365-2036

pii

APT2760

journal_volume

23

pub_type

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