Effectiveness of Zinc Supplementation with ORS and Bacillus clausii versus zinc with ORS and Saccharomyces boulardii in Acute Watery Diarrhea in Pediatric Patients

Background: Acute watery diarrhea (AWD) remains a leading cause of death in children. Probiotics, when used alongside standard therapy, can improve clinical outcomes. Objective: To compare the effectiveness of Bacillus clausii versus Saccharomyces boulardii, each combined with zinc and oral rehydration solution (ORS), in the management of AWD in children. Method: This randomized controlled trial was conducted in the Department of Pediatric Medicine, Children’s Hospital Lahore, from April to September 2023. Sixty children aged 3 months to 5 years with AWD and mild to moderate dehydration were randomly assigned to Group A (Bacillus clausii + Zinc + ORS) or Group B (Saccharomyces boulardii + Zinc + ORS). Primary outcomes were stool frequency and consistency; secondary outcome was hospital stay duration. Results: In a total of 60 children, 30 each group, 28 (46.7%) were male. Both groups showed decreased stool frequency from day 1 to day 5. Group A reduced from 4.43 ± 1.72 to 1.56 ± 0.57 stools per day, while Group B decreased from 4.96 ± 1.56 to 1.76 ± 0.63 stools per day. Group A had a higher efficacy rate (96.7%) compared to Group B (90%) and faster symptom improvement (2.48 ± 0.74 days vs. 3.14 ± 1.06 days, p = 0.007). Group A had a shorter mean hospital stay (34.86 hours vs. 48.40 hours, p=0.014). Conclusion: Bacillus clausii in comparison to Saccharomyces boulardii is more effective in reducing the duration as well as frequency of diarrhea in children.