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KMID : 1038520180400010043
Epidemiology and Health
2018 Volume.40 No. 1 p.43 ~ p.43
Prophylactic efficacy of probiotics on travelers¡¯ diarrhea: an adaptive meta-analysis of randomized controlled trials
Bae Jong-Myon

Abstract
OBJECTIVES: The 2017 guideline for the prevention of travelers¡¯ diarrhea (TD) by the International Society of Travel Medicine suggested that ¡®there is insufficient evidence to recommend the use of commercially available prebiotics or probiotics to prevent or treat TD.¡¯ However, a meta-analysis published in 2007 reported significant efficacy of probiotics in the prevention of TD (summary relative risk [sRR], 0.85, 95% confidence interval [CI], 0.79 to 0.91). This study aimed to synthesize the efficacy of probiotics on TD by updating the meta-analysis of double-blind, placebo-controlled, randomized human trials.

METHODS: The search process was conducted by the adaptive meta-analysis method using the ¡®cited by¡¯ and ¡®similar articles¡¯ options provided by PubMed. The inclusion criteria were double-blind, placebo-controlled, randomized human trials with hypotheses of probiotics as intervention and TD as an outcome. The adaptive meta-analysis was conducted using Stata software using the csi, metan, metafunnel, and metabias options.

RESULTS: Eleven articles were selected for the meta-analysis. The sRR was 0.85 (95% CI, 0.79 to 0.91) and showed statistical significance. There was no heterogeneity (I-squared=28.4%) and no publication bias.

CONCLUSIONS: Probiotics showed statistically significant efficacy in the prevention of TD.
KEYWORD
Probiotics, Diarrhea, Randomized controlled trials, Meta-analysis
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