Browsing by Author "Padayachee, Morgambal"

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    Efficacy and safety of saccharomyces boulardii in the treatment of acute gastroenteritis in the paediatric population : a systematic review
    (MedPharm Publications, 2018-04-12) Padayachee, Morgambal; Visser, Janicke; Viljoen, Estelle; Musekiwa, Alfred; Blaauw, Renee
    Context: Gastroenteritis (GE) remains the second major cause of death in the most vulnerable of the world’s populations. Potential treatments include the use of probiotics, with the yeast Saccharomyces boulardii being one such option. Objectives: The primary objective was to assess the efficacy and safety of Saccharomyces boulardii in the treatment of acute GE in the paediatric population. Method: Major electronic databases were searched from April 2014 to January 2015. Additional literature was obtained through hand-searching and reviewing of reference lists of articles and other systematic reviews. Randomised controlled trials (RCTs) in a hospital setting, involving participants < 16 years were used as the data source. Two reviewers independently screened studies for eligibility, assessed study quality and performed data extraction. Review Manager 5 was used to analyse data and a random-effects model of meta-analysis was applied owing to heterogeneity. Results: Ten of 190 articles were selected for final inclusion. A meta-analysis of five of the included studies showed that Saccharomyces boulardii compared with the control significantly shortened the duration of diarrhoea (in days) (MD –0.57, 95% CI –0.83 to –0.30, p < 0.0001), but there was no difference between groups regarding time to achieving formed stools. No adverse effects were reported. The GRADE tool assessed overall methodological quality as moderate. Conclusion: Saccharomyces boulardii showed a potential benefit in treating acute GE in the paediatric patient. A dose of 250 mg 1–2 times per day for up to 5 days showed some benefit and appears safe. Larger, rigorous RCTs are needed to investigate the efficacy and safety of Saccharomyces boulardii in order to offer specific treatment guidelines.
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    A systematic review of the efficacy and safety of Saccharomyces boulardii in the treatment of acute gastroenteritis in the pediatric population
    (Stellenbosch : Stellenbosch University, 2016-12) Padayachee, Morgambal; Blaauw, Renee; Visser, Janicke; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.
    ENGLISH SUMMARY : Background: The yeast Saccharomyces boulardii has been classed a probiotic because it is a live microorganism known to confer a health benefit to its host, with one such benefit being in the management of gastrointestinal disturbances like gastroenteritis. Gastroenteritis is known to be the second leading cause of death in the world’s most vulnerable populations, with Rotavirus being the most common causative agent, responsible for 215,000 global child deaths during 2013. Together with a few other probiotics, Saccharomyces boulardii has been considered a potentially viable treatment option having been associated with a decreased duration of diarrhea, decreased number of days to the first formed stool, and decreased duration of hospital stay in individual studies. This systematic review was therefore designed to specifically investigate the effects of Saccharomyces boulardii on acute gastroenteritis caused by Rotavirus in the pediatric hospitalized patient. Objectives: To assess the efficacy and safety of Saccharomyces boulardii in the treatment of acute gastroenteritis in the pediatric population. Secondary objectives of cost-effectiveness in terms of length of hospital stay; optimal dosing and administration routes were also investigated. Methods: Data sources included Medline, CINAHL, Scopus and The Cochrane Library up to and including August 2015. Only randomized controlled trials in a hospital setting and involving subjects less than 16 years were included. Two reviewers independently evaluated studies for eligibility, quality and extracted the data. Data were analyzed using Review Manager 5 (RevMan 2008) software. A random effects model of meta-analysis was used due to the presence of heterogeneity of treatment effects between studies. Results: Out of a pool of 190 articles, 10 studies were selected for final inclusion and analysis. A meta-analysis involving five of the ten included studies showed that Saccharomyces boulardii significantly shortened the duration of diarrhea (in days), compared to the control/placebo group (MD -0.57, 95%CI: -0.83 to -0.30, P < 0.0001). Also, participants were passing solid stools in the Saccharomyces boulardii group compared to the control group on Day 2 (RR 3.00; 95% CI: 0.32 to 27.87), Day 3 (RR 3.17; 95% CI: 1.89 to 5.31), Day 4 (RR 1.63; 95% CI: 1.30 to 2.06) and Day 5 (RR 1.25; 95% CI: 1.08 to 1.44), (P = 0.06). Other outcomes like number of participants having less than three stools per day during the intervention and duration of hospital stay did not produce any statistically significant results. No studies reported on any significant adverse effects associated with the use of Saccharomyces boulardii. Conclusion: The results of the current systematic review appear to indicate there’s a potential benefit with using Saccharomyces boulardii to treat acute gastroenteritis in the pediatric patient. Offering this unique yeast probiotic at a dose of 250mg once to twice per day for up to five days has shown some benefit and appears to be safe. However, larger and more rigorous controlled trials are needed to further investigate the efficacy and safety of individual probiotics, like Saccharomyces boulardii, in order to offer specific treatment guidelines.