Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region

Table 2 Proposed recommendations for the Asia-Pacific region with grade and strength of recommendations

Disease		Recommendation	Strains	Grade	Weak
Acute gastroenteritis	T	Should be considered1	S. boulardii,	Moderate quality	Strong
			L. rhamnosus GG		Strong
			L reuteri		Weak
AAD	P	May be considered	L. rhamnosus GG	Moderate quality	Strong
			S. boulardii		Strong
CDAD	P	May be considered	S. boulardii	Low quality	Weak
Nosocomial diarrhea	P	Can be considered	L. rhamnosus GG	Moderate quality	Weak
Traveler’s diarrhea	P	Not recommended		Very low quality	Weak
Functional intestinal disorders	T	Not recommended		Very low quality	Weak
Infant colics	T	May be considered	L. reuteri	Moderate quality	Weak
IBD (Crohn’s disease, ulcerative colitis)	T	Not recommended		Low quality	Weak
Helicobacter pylori infection	T	May be considered	S. boulardii,	Very low quality	Weak2
			others		Weak
Necrotizing enterocolitis		Decision to be discussed with parents	Various (Bifidobacterium, Lactobacillus species)

¹In adjunct to oral rehydration therapy and with the exclusion of malnourished children;

²For prevention of antibiotic-induced side effects and possible increase in eradication rates. T: Treatment; P: Prevention; AAD: Antibiotic-associated diarrhea; CDAD: Clostridium difficile-associated diarrhea; IBD: Inflammatory bowel disease.