Effectiveness of Saccharomyces Boulardii in Prevention of Antibiotic Associated Diarrhea

August 20, 2026 updated by: Gul Jabeen, University of Child Health Sciences and Children's Hospital, Lahore

Effectiveness of Saccharomyces Boulardii in the Prevention of Antibiotic-Associated Diarrhea Among Children Receiving Co-amoxiclav for Upper Respiratory Tract Infection: A Randomized Control Trial

Antibiotic-associated diarrhea (AAD) is a common adverse effect in pediatric patients receiving broad-spectrum antibiotics such as co-amoxiclav for upper respiratory tract infections (URTI). This study aims to evaluate the effectiveness of the probiotic Saccharomyces boulardii in preventing antibiotic-associated diarrhea among children aged 6 months to 5 years receiving co-amoxiclav. Participants will be randomly allocated to receive either standard co-amoxiclav therapy alone or co-amoxiclav combined with Saccharomyces boulardii for 5 days. The primary objective is to evaluate whether the addition of Saccharomyces boulardii reduces the incidence of diarrhea during and up to 14 days following antibiotic therapy.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Acute upper respiratory tract infections (URTI) frequently lead to broad-spectrum antibiotic prescriptions such as co-amoxiclav, which can disrupt the gut microbiota and cause antibiotic-associated diarrhea (AAD).

This single-blind randomized controlled trial will be conducted at the Pediatric Medicine Outpatient Department, University of Child Health Sciences, The Children's Hospital, Lahore. A total of 88 children aged 6 months to 5 years presenting with URTI and prescribed co-amoxiclav will be enrolled after obtaining written informed consent from their parents or legal guardians.

Participants will be randomized into two equal groups (n = 44 each):

Group A (Control): Standard dose of oral co-amoxiclav (30 mg/kg/day) for 5 days.

Group B (Intervention): Standard dose of oral co-amoxiclav (30 mg/kg/day) plus oral Saccharomyces boulardii for 5 days.

Clinical response, stool frequency, and stool consistency (graded using the WHO scale) will be assessed telephonically and during clinical follow-up at Day 5 (completion of antibiotic regimen) and at Day 14. Any child developing severe dehydration or high-grade loose stools will be managed in accordance with institutional safety protocols.

Study Type

Interventional

Enrollment (Estimated)

88

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan
        • University of Child Health sciences, Children's hospital,Lahore
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Children aged 6 months to 5 years presenting with upper respiratory tract infection (URTI)
  • Prescribed standard oral co-amoxiclav therapy
  • Both male and female patients
  • Written informed consent provided by parents or legal guardians

Exclusion Criteria:

  • Presence of diarrhea at the time of study enrollment
  • Prior use of probiotics during the current course of illness
  • Receipt of any antibiotic other than co-amoxiclav within the 72 hours preceding enrollment
  • Concomitant use of other medications
  • Known allergy to co-amoxiclav or the probiotic Saccharomyces boulardii
  • Confirmed immunodeficiency disorder or current receipt of immunosuppressive therapy
  • History of chronic diarrhea
  • Presence of 3rd degree (severe) malnutrition
  • Presence of systemic symptoms or infections other than URTI (e.g., lower respiratory tract infection, jaundice)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Group A: Control Group
Participants receive standard oral co-amoxiclav (30 mg/kg/day) for 5 days.
Drug: Co-amoxiclav
30 mg/kg/day orally for 5 days.
Experimental: Group B:Intervention Group
Participants receive standard oral co-amoxiclav (30 mg/kg/day) plus oral Saccharomyces boulardii for 5 days.
Drug: Co-amoxiclav
30 mg/kg/day orally for 5 days.
Dietary supplement: Saccharomyces boulardii
Administered orally alongside standard co-amoxiclav for 5 days.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence of Antibiotic-Associated Diarrhea (AAD)
Time Frame: From initiation of treatment through Day 14
Proportion of participants who develop antibiotic-associated diarrhea, defined as 3 or more unformed/loose stools per day or a single episode of watery stool starting at least 2 hours post-initiation of co-amoxiclav therapy.
From initiation of treatment through Day 14

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Stool Frequency
Time Frame: Assessed at Day 1, Day 5, and Day 14.
Number of stool passages per day categorized on a standardized scale (Nil, 1-2, 3-4, >4 times per day).
Assessed at Day 1, Day 5, and Day 14.
Stool Consistency Grade
Time Frame: Assessed at Day 1, Day 5, and Day 14
Stool consistency graded according to the WHO grading scale: Grade 1 (Normal formed), Grade 2 (Semi-formed), Grade 3 (Liquid stools taking shape of container), Grade 4 (Watery stools with flakes, opaque), Grade 5 (Watery stools with few flakes, translucent).
Assessed at Day 1, Day 5, and Day 14
Duration of Diarrhea
Time Frame: Up to Day 14 post-initiation of therapy
Total duration (in days) of diarrheal episodes in participants who develop antibiotic-associated diarrhea.
Up to Day 14 post-initiation of therapy

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Child Health Sciences and Children's Hospital, Lahore

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

February 1, 2027

Study Completion (Estimated)

May 1, 2027

Study Registration Dates

First Submitted

August 20, 2026

First Submitted That Met QC Criteria

August 20, 2026

First Posted (Actual)

August 25, 2026

Study Record Updates

Last Update Posted (Actual)

August 25, 2026

Last Update Submitted That Met QC Criteria

August 20, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UCHS-MD-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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