Comparison of Bacillus Clausii and Saccharomyces Boulardii for Acute Diarrhea at Day 3

This study is planning to compare the clinical efficacy of bacterial ( Bacillus clausii) versus fungal (Sacchromyces boulardii) probiotic in acute watery diarrhea. A clear consensus has not been reached regarding the use of appropriate probiotic. Some pediatricians are of the opinion that bacterial probiotic are suprerior to fungal probiotics along with rehydration for improvement of diarrhea. However, others experience is that fungal probiotics are better along with rehydration for the improvement of diarrhea. A high-quality evidence basis must be established that guides the pediatrician regarding the choice of probiotic.The results of this study will help guide pediatricians to the better probiotic for the clinical improvement of acute diarrhea in our setup.

• Bacillus clausii (Dietary supplement): Bacillus clausii, a bacterial-based probiotic, will be administered orally at a dose of 2 billion spores twice daily for 3 days, in addition to standard diarrheal treatment. Clinical efficacy will be assessed on the 3rd day based on stool frequency and consistency.
• Saccharomyces boulardii (Dietary supplement): Saccharomyces boulardii, a fungal-based probiotic, will be administered orally at a dose of 250 mg twice daily for 3 days, in addition to standard diarrheal treatment. Clinical efficacy will be assessed on the 3rd day based on stool frequency and consistency.

Primary outcomes

• Clinical efficacy of probiotic treatment [3 days]: Clinical efficacy will be assessed on the 3rd day. A positive outcome will be defined as ≤3 episodes of stool with Bristol stool grade 5 or less. The clinical efficacy of Bacillus clausii will be compared with Saccharomyces boulardii in children with acute watery diarrhea.

Sex: All, ages: 0 Months to 59 Months

Inclusion Criteria:

1. Children aged 0 to 59 months
2. Acute Watery Diarrhea
3. The child's parents or caregiver understands, agrees to participate, and complies with the study protoco

Exclusion Criteria:

1. Patients with bloody diarrhea, severe dehydration, severe electrolyte imbalance, immunocompromised children, or malabsorption disorders and systemic illnesses (sepsis, pneumonia, urinary infections)
2. Those who have already used antibiotics or probiotics during this illness
3. Known hypersensitivity to probiotics

• Awais M, Alam S, Wali N, Mehmood R, Nasir U, Waheed A. Comparison of the Clinical Efficacy of Bacteria-Based Probiotics to Fungi-Based Probiotics. 7.
• Sharif A, Ardakani AT, Kashani HH, Rabiee F, Sharif MR. Comparison Efficacy of Bacterial and Fungal Probiotics on Acute Pediatric Diarrhea A Randomized Clinical Trial [Internet]. 2019 [cited 2024 Sept 3]. Available from: https://www.researchsquare.com/article/rs-2183/v1
• Erdogan O, Tanyeri B, Torun E, Gonullu E, Arslan H, Erenberk U, Oktem F. The comparition of the efficacy of two different probiotics in rotavirus gastroenteritis in children. J Trop Med. 2012;2012:787240. doi: 10.1155/2012/787240. Epub 2012 Jun 19. PMID 22778754
• Khan MH, Khan MS. Comparison of Multispecies Probiotic and Saccahomyces Boulardii in Children with Acute Watery Diarrhea in Terms of Mean Duration of Diarrhea.
• Sharma AK, Puri N, Mathur M, Mathur A. A randomized controll trial to compare the efficacy of saccharomyces boulardii, bacillus clausii, and lactobacillus rhamnosus GG preparation in the treatment of acute diarrhea in children. Asian J Pharm Clin Res. 2022 Mar 14;63-7.
• Syed M, Gondi S, D V, P U. Study on efficacy of probiotic use in pediatric acute diarrhea: A prospective open-labeled study. Natl J Physiol Pharm Pharmacol. 2023;14(5):1

• Study Protocol, Statistical Analysis Plan, and Informed Consent Form (PDF, 2024-09-23)
• Study Protocol and Informed Consent Form (PDF, 2024-09-23)