What does this research mean for the field?

The addition of Saccharomyces boulardii CNCM I-745 to smectite significantly improves cure rates and reduces the duration of pediatric acute gastroenteritis in children. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

This study aimed to evaluate the effectiveness of adding Saccharomyces boulardii CNCM I-745 to smectite in treating pediatric acute gastroenteritis.

February 22, 2026Frontiers in Pediatrics0 citationsOpen Access

Saccharomyces boulardii CNCM I-745 and smectite treatment for pediatric acute gastroenteritis in China: a systematic review and meta-analysis

TLT LiDalian Medical University LMLynne Vernice McFarlandUnited States Army Reserve

Key Points

This study aimed to evaluate the effectiveness of adding Saccharomyces boulardii CNCM I-745 to smectite in treating pediatric acute gastroenteritis.
Conducted systematic searches in multiple databases for relevant randomized controlled trials.
Included studies were conducted in China and focused on children with pediatric acute gastroenteritis.
Data on various outcomes related to gastroenteritis, such as cure rates and length of hospitalization, were extracted and analyzed.
S. boulardii CNCM I-745 improved the cure rate (RR = 1.45).
It reduced the duration of pediatric acute gastroenteritis by approximately 1.54 days.
The total effectiveness rating improved (RR = 1.21), and adverse events decreased (RR = 0.64).

Abstract

Introduction Pediatric acute gastroenteritis (PAGE) is a common cause of morbidity and mortality, especially among children under 5 years of age. Standard treatments typically include rehydration therapy, dietary modifications, antimicrobials, and adjunctive treatments with smectite or specific probiotics. The efficacy of adding Saccharomyces boulardii to standard treatments, including regimens that already incorporate smectites, remains not well known. Most trials evaluating this combination have been published in Chinese, which has limited global awareness of this type of treatment. Aim This study aimed to meta-analytically examine whether the addition of S. boulardii CNCM I-745 to smectite is more effective in treating PAGE than smectite alone. Methods Systematic searches were conducted in PubMed, Google Scholar, China National Knowledge Infrastructure, and the China Biology Medicine database up to 20 February 2025 receiving smectites. Eligible studies were randomized controlled trials conducted in China that compared S. boulardii CNCM I-745 with controls in children with PAGE receiving smectites, with no language restrictions. Data were independently extracted using standardized forms, including outcomes related to PAGE (cured, duration of PAGE, length of hospitalization, and immune markers) and potential confounding variables (dose, disease etiology). Results Of 57 included trials (5,767 participants), S. boulardii CNCM I-745 significantly improved the cure rate (RR = 1.45, 95% CI 1.38, 1.53), reduced the duration of PAGE (SMD = −1.54 days, 95% CI −1.79, −1.29), improved the total effectiveness rating (RR = 1.21, 95% CI 1.18, 1.24), and reduced adverse events (RR = 0.64, 95% CI 0.43, 0.97). Conclusion S. boulardii CNCM I-745 significantly improved cure rates, reduced the duration of PAGE, decreased stool frequency and vomiting, and shortened hospitalization duration, while being well-tolerated. Systematic Review Registration http://www.crd.york.ac.uk/PROSPERO , PROSPERO #CRD42024567537.

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