THE ROLE OF PROBIOTICS AND PREBIOTICS IN THE TREATMENT OF INTESTINAL INFECTIONS IN CHILDREN: A SYSTEMATIC REVIEW

Abstract

 Objective: Intestinal infections, particularly acute gastroenteritis, are a leading cause of morbidity and mortality in children worldwide. Standard treatment primarily focuses on rehydration and nutritional support. This systematic review aims to synthesize and evaluate the existing evidence on the efficacy and safety of probiotics and prebiotics as an adjunct therapy in the management of intestinal infections in the pediatric population. Methods: A systematic literature search was conducted using PubMed, Scopus, and Google Scholar for studies published between 2015 and 2025. Search terms included "probiotics," "prebiotics," "synbiotics," "intestinal infections," "gastroenteritis," "diarrhea," and "children." The review included randomized controlled trials (RCTs), meta-analyses, and systematic reviews. The primary outcomes assessed were the duration of diarrhea, stool frequency, and duration of hospitalization. Data were synthesized qualitatively. Results: The analysis of 45 selected studies revealed that specific probiotic strains, notably Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii, significantly reduce the duration of acute infectious diarrhea by an average of 24 to 30 hours compared to placebo or standard treatment alone. These probiotics were also associated with a reduction in stool frequency and a shorter duration of hospitalization. Evidence for prebiotics, such as fructo-oligosaccharides (FOS) and galacto-oligosaccharides (GOS), suggests a beneficial role in modulating gut microbiota and preventing infections, although their therapeutic efficacy in acute settings is less established than for probiotics. Synbiotics (combinations of probiotics and prebiotics) show promise, with some studies indicating a synergistic effect that may enhance treatment outcomes. The safety profile of these interventions was found to be excellent in immunocompetent children. Conclusion: The evidence strongly supports the use of specific, well-documented probiotic strains as an effective and safe adjunct therapy for treating acute infectious diarrhea in children. While prebiotics and synbiotics are promising, more robust clinical trials are required to establish definitive recommendations for their use in acute intestinal infections. Future research should focus on strain-specific effects, optimal dosing, and their role in different etiological contexts.