- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00760773
Impact of Emergency Department Probiotic Treatment of Diarrheal Illness on Daycare Attendance
Impact of Emergency Department Probiotic Treatment of Diarrheal Illness on Daycare Attendance: Randomized Controlled Trial and Economic Analysis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Gastroenteritis in children utilizes significant health care resources and has a significant impact on children, caregivers and society. In the United States, gastroenteritis accounts for more than 1.5 million outpatient visits and 200,000 hospitalizations per year. Data from British Columbia indicate that gastroenteritis annually accounts for 12 million missed workdays by adults and 10 million missed school days by children in this province alone. Canadian data, including the cost of work absenteeism, report the mean annual cost/gastroenteritis case to be $1,089.
Although medications have not routinely been recommended, acute gastroenteritis in children can result in significant morbidity. Thus, physicians and caregivers desire treatment options to reduce the burden of disease. Recently, ondansetron, an antiemetic agent has been found to be effective in pediatric gastroenteritis, and is now frequently employed to reduce vomiting. Probiotics agents may represent another valuable treatment option. Since the early 1990s, research has been conducted on the effects of probiotics, defined as viable microbial preparations that have a beneficial effect on the health and well being of the host.
A recent Cochrane Database systematic review recently concluded that "probiotics appear to be a useful adjunct to rehydration therapy in treating acute, infectious diarrhea." However, the review also concluded that more research is needed to determine which specific probiotic regimens should be employed in specific patient groups. The later statement is of particular importance in North America as probiotics are not a mainstay of clinical practice. While only 18% of Canadian physicians are aware of research on probiotics, 82% feel that more probiotic research is needed, and 76% feel there is a role for probiotics in their practice. This discrepancy likely is due to the absence of probiotic trials in North American patients and because the outcome measures evaluated often have had limited clinical applicability. Since most episodes of acute diarrhea require no specific treatment, cost-effectiveness analyses are also required before the widespread use of probiotics can be endorsed.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Ontario
-
Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario
-
Toronto, Ontario, Canada
- The Hospital for Sick Children
-
-
Quebec
-
Montreal, Quebec, Canada
- Hospital Sainte Justine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Acute gastroenteritis as determined by the supervising physician.
- Attend daycare
- Presence of diarrhea.
- Duration of vomiting or diarrhea less than 96 hours.
- Age greater than 90 days
- Age less than 48 months
Exclusion Criteria:
- Presence of an indwelling vascular access line or congenital heart disease.
- Taking immunosuppressive therapy or history of immunodeficiency (including all primary, secondary and acquired states)
- Have recently had cardiac, oral or gastrointestinal surgery
- Pancreatic dysfunction or bloody diarrhea
- History of: hematochezia, underlying chronic gastrointestinal problem, short bowel syndrome or inflammatory bowel disease
- Family member with an indwelling vascular access line, on immunosuppressive therapy or with a known immunodeficiency
- Undergoing radiation therapy
- Exclusively breastfed
- Bilious or bloody vomitus
- Previously enrolled in this trial
- Inability to speak or read English
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1
|
Each sachet will contain a minimum of 4 billion CFU/sachet.
The total weight of all ingredients is 1 gm.
All patients in this arm of the study will take 1 sachet twice daily for 5 days.
Doses should be ideally separated by 12 hours (minimum of 8 hours) and taken within 30 minutes of food/drink.
If the child vomits within 15 minutes of medication administration (initial or subsequent dose), the dose will be repeated.
Subjects in this arm will receive the high dose which will consist of 4 billion CFU (1 active sachet) PO BID (total daily dose = 8 billion CFU) x 5 days.
|
Experimental: 2
|
Each sachet will contain a minimum of 4 billion CFU/sachet.
The total weight of all ingredients is 1 gm.
All patients in this arm of the study will take 1 sachet twice daily for 5 days.
Doses should be ideally separated by 12 hours (minimum of 8 hours) and taken within 30 minutes of food/drink.
If the child vomits within 15 minutes of medication administration (initial or subsequent dose), the dose will be repeated.
Subjects in this arm will receive the standard dose which will consist of 4 billion CFU (1 active sachet) PO QAM (total daily dose = 4 billion CFU) plus 1 placebo sachet PO QHS x 5 days.
|
Placebo Comparator: 3
|
The total weight of all ingredients is 1 gm.
All patients in this arm of the study will take 1 sachet twice daily for 5 days.
Doses should be ideally separated by 12 hours (minimum of 8 hours) and taken within 30 minutes of food/drink.
If the child vomits within 15 minutes of medication administration (initial or subsequent dose), the dose will be repeated.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Proportion of children missing a day of daycare related to vomiting, diarrhea, dehydration, fever, or fluid refusal.
Time Frame: 2 weeks
|
2 weeks
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Return visits for unscheduled care to a health care provider related to vomiting, diarrhea, dehydration, fever, or fluid refusal.
Time Frame: 2 weeks
|
2 weeks
|
Intravenous rehydration
Time Frame: 2 weeks
|
2 weeks
|
Duration of diarrhea
Time Frame: Meaured by outcome
|
Meaured by outcome
|
Duration of vomiting
Time Frame: Meaured by outcome
|
Meaured by outcome
|
Number of days the child does not go to daycare.
Time Frame: Measured by outcome
|
Measured by outcome
|
Work absenteeism
Time Frame: 2 weeks
|
2 weeks
|
Economic analysis
Time Frame: 2 weeks
|
2 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Stephen Freedman, MD, The Hospital for Sick Children
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1000012686
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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