Impact of Emergency Department Probiotic (LGG) Treatment of Pediatric Gastroenteritis
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
-
-
California
-
Sacramento, California, United States, 95817
- UC Davis Medical Center
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-
District of Columbia
-
Washington, District of Columbia, United States, 20010
- Children's National Medical Center
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-
Illinois
-
Chicago, Illinois, United States, 60611
- Lurie Children's Hospital
-
-
Michigan
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Ann Arbor, Michigan, United States, 48109
- University of Michigan Health System
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Detroit, Michigan, United States, 48201
- Children's Hospital of Michigan
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-
Missouri
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Saint Louis, Missouri, United States, 63110
- St. Louis Children's Hospital
-
-
New Mexico
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Albuquerque, New Mexico, United States, 87106
- University of New Mexico
-
-
New York
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New York, New York, United States, 10032
- Children's Hospital of New York
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Ohio
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Cincinnati, Ohio, United States, 45229
- Cincinnati Children's Hospital
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Rhode Island
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Providence, Rhode Island, United States, 02903
- Hasbro Children's Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 3-48 months (have not yet reached their fourth birthday); AND
- Presence of 3 or more watery stools within 24 hours of screening; AND
- Duration of vomiting or diarrhea less than 7 days; AND
- Symptoms consistent with acute intestinal infectious process.
Exclusion Criteria:
- Presence of an indwelling vascular access line; OR
- Presence of structural heart disease excluding non-pathological heart murmurs; OR
- Receiving immunosuppressive therapy or history of immunodeficiency; OR
- Hematochezia in the preceding 48 hours; OR
- Chronic gastrointestinal problems (e.g. short gut syndrome, inflammatory bowel disease); OR
- Patients with known pancreatitis; OR
- History of abdominal surgery; OR
- Critically ill patients; OR
- Family member with an indwelling vascular access line, or on immunosuppressive therapy, or with a known immunodeficiency; OR
- Bilious emesis; OR
- Probiotic use (supplement) in the preceding 2 weeks; OR
- Oral or intravenous steroid use in the preceding six months; OR
- Previously enrolled in this trial; OR
- Allergy to lactobacillus or Microcrystalline Cellulose (MCC); OR
- Allergy to erythromycin, clindamycin, AND betalactam antibiotics (all); OR
- Not available for daily follow-up while symptomatic; OR
- Parent/guardian not speaking English or Spanish; OR
- Under 6 months old AND premature (<37 weeks).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: LGG
LGG 10^10 cfu PO bid x 5 days
|
LGG 10^10 cfu PO BID X 5 days
Other Names:
|
|
PLACEBO_COMPARATOR: Placebo
micro-crystalline cellulose PO bid x 5 days
|
1 capsule PO bid x 5 days
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Modified Vesikari Scale Score >=9
Time Frame: 14 days
|
This is a validated gastroenteritis severity score that includes duration and frequency of diarrhea, duration and frequency of vomiting, duration and frequency of fever and use of health care resources.
Scores >=9 indicate moderate-severe gastroenteritis.
Higher is worse.
|
14 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With LGG Bacteremia
Time Frame: 1 month
|
bacteremia caused by LGG
|
1 month
|
|
Diarrhea Duration
Time Frame: 14 days
|
diarrhea duration in hours after randomization
|
14 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Kimberly Quayle, MD, Washington University School of Medicine
Publications and helpful links
General Publications
- Freedman SB, Finkelstein Y, Pang XL, Chui L, Tarr PI, VanBuren JM, Olsen C, Lee BE, Hall-Moore CA, Sapien R, O'Connell K, Levine AC, Poonai N, Roskind C, Schuh S, Rogers A, Bhatt S, Gouin S, Mahajan P, Vance C, Hurley K, Powell EC, Farion KJ, Schnadower D. Pathogen-Specific Effects of Probiotics in Children With Acute Gastroenteritis Seeking Emergency Care: A Randomized Trial. Clin Infect Dis. 2022 Aug 24;75(1):55-64. doi: 10.1093/cid/ciab876.
- Schnadower D, O'Connell KJ, VanBuren JM, Vance C, Tarr PI, Schuh S, Hurley K, Rogers AJ, Poonai N, Roskind CG, Bhatt SR, Gouin S, Mahajan P, Olsen CS, Powell EC, Farion K, Sapien RE, Chun TH, Freedman SB; Pediatric Emergency Care Applied Research Network and Pediatric Emergency Research Canada. Association Between Diarrhea Duration and Severity and Probiotic Efficacy in Children With Acute Gastroenteritis. Am J Gastroenterol. 2021 Jul 1;116(7):1523-1532. doi: 10.14309/ajg.0000000000001295.
- Freedman SB, Roskind CG, Schuh S, VanBuren JM, Norris JG, Tarr PI, Hurley K, Levine AC, Rogers A, Bhatt S, Gouin S, Mahajan P, Vance C, Powell EC, Farion KJ, Sapien R, O'Connell K, Poonai N, Schnadower D; Pediatric Emergency Research Canada and Pediatric Emergency Care Applied Research Networks. Comparing Pediatric Gastroenteritis Emergency Department Care in Canada and the United States. Pediatrics. 2021 Jun;147(6):e2020030890. doi: 10.1542/peds.2020-030890. Epub 2021 May 20.
- Poonai N, Powell EC, Schnadower D, Casper TC, Roskind CG, Olsen CS, Tarr PI, Mahajan P, Rogers AJ, Schuh S, Hurley KF, Gouin S, Vance C, Farion KJ, Sapien RE, O'Connell KJ, Levine AC, Bhatt S, Freedman SB; Pediatric Emergency Care Applied Research Network (PECARN) and Pediatric Emergency Research Canada (PERC). Variables Associated With Intravenous Rehydration and Hospitalization in Children With Acute Gastroenteritis: A Secondary Analysis of 2 Randomized Clinical Trials. JAMA Netw Open. 2021 Apr 1;4(4):e216433. doi: 10.1001/jamanetworkopen.2021.6433. Erratum In: JAMA Netw Open. 2021 Jun 1;4(6):e2116800.
- Schnadower D, Sapien RE, Casper TC, Vance C, Tarr PI, O'Connell KJ, Levine AC, Roskind CG, Rogers AJ, Bhatt SR, Mahajan P, Powell EC, Olsen CS, Gorelick MH, Dean JM, Freedman SB; Pediatric Emergency Care Applied Research Network (PECARN) Probiotics Study. Association between Age, Weight, and Dose and Clinical Response to Probiotics in Children with Acute Gastroenteritis. J Nutr. 2021 Jan 4;151(1):65-72. doi: 10.1093/jn/nxaa313.
- Schnadower D, Tarr PI, Casper TC, Gorelick MH, Dean JM, O'Connell KJ, Mahajan P, Levine AC, Bhatt SR, Roskind CG, Powell EC, Rogers AJ, Vance C, Sapien RE, Olsen CS, Metheney M, Dickey VP, Hall-Moore C, Freedman SB. Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children. N Engl J Med. 2018 Nov 22;379(21):2002-2014. doi: 10.1056/NEJMoa1802598.
- Schnadower D, Tarr PI, Casper TC, Gorelick MH, Dean MJ, O'Connell KJ, Mahajan P, Chun TH, Bhatt SR, Roskind CG, Powell EC, Rogers AJ, Vance C, Sapien RE, Gao F, Freedman SB. Randomised controlled trial of Lactobacillus rhamnosus (LGG) versus placebo in children presenting to the emergency department with acute gastroenteritis: the PECARN probiotic study protocol. BMJ Open. 2017 Sep 24;7(9):e018115. doi: 10.1136/bmjopen-2017-018115.
- Freedman SB, Williamson-Urquhart S, Schuh S, Sherman PM, Farion KJ, Gouin S, Willan AR, Goeree R, Johnson DW, Black K, Schnadower D, Gorelick MH; Pediatric Emergency Research Canada (PERC) Gastroenteritis Study Group. Impact of emergency department probiotic treatment of pediatric gastroenteritis: study protocol for the PROGUT (Probiotic Regimen for Outpatient Gastroenteritis Utility of Treatment) randomized controlled trial. Trials. 2014 May 14;15:170. doi: 10.1186/1745-6215-15-170.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 1R01HD071915 (NIH)
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