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

Department of Pediatric Gastroenterology and Nutrition, The Medical University of Warsaw, Warsaw, Poland.
Alimentary Pharmacology & Therapeutics (Impact Factor: 5.73). 02/2006; 23(2):217-27. DOI: 10.1111/j.1365-2036.2006.02760.x
Source: PubMed


Although not currently recommended, dioctahedral smectite (smectite) is commonly used to treat acute infectious diarrhoea in many countries.
To evaluate systematically the effectiveness of smectite in treating acute infectious diarrhoea in children.
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.
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.
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.

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Available from: Piotr Dziechciarz, Sep 21, 2014
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    BMC Pregnancy and Childbirth 04/2014; 14(1):144. DOI:10.1186/1471-2393-14-144 · 2.19 Impact Factor
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    • "There was a diet effect on goblet cell size in the colon (Table 4) in which the clays generally increased goblet cell size, mostly in the sham group. These modest increases in goblet cell size and number during the acute phase of the infection when clays were fed may reflect enhanced protection and may at least partially explain the reduction in diarrhea observed previously in pigs [8] and children [24]. "
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    Journal of Animal Science and Biotechnology 12/2013; 4(1):52. DOI:10.1186/2049-1891-4-52 · 1.68 Impact Factor
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    • "One of the most remarkable pharmacological characteristics of smecta is its strong adsorption activity.[17] It not only adsorbs eight times its own weight of water, but also adsorbs toxins, bacteria, and rotavirus, keeping virulence factors from adhering to intestinal membranes.[18–20] In addition, with the ability to cover the mucosa and to combine with mucous glycoprotein, smecta strengthens the mucosal barrier.[21] "
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    03/2013; 4(2):144-50. DOI:10.5847/wjem.j.1920-8642.2013.02.011
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