Zinc and symbiotic in acute gastroenteritis in Italian children: A pilot study

Aim: To evaluate the clinical effect of zinc and a specific symbiotic in acute diarrhoea in Italian children. Patients and methods: Prospective double blind randomized controlled trial with 60 children (>1<3 years) hospitalized for acute enteritis (> 3 loose stools in the last 24 hours with duration <48 hours preadmission). Three groups of treatment (2 sachets per day for 7 days): A (N=21), placebo (maltodextrins), B (N=18), zinc (10 mg of pidolate zinc per sachet) alone, C (N=21), symbiotic (Probiotec® FD AB blend: LA‐5® Lactobacillus acidophilus plus BB‐12® Bifidobacterium, and Streptococcus thermophilus, ≥1×109 cfu per strain per sachet plus short chain fructans and galactans, 300 mg and 700 mg per sachet) with zinc (10 mg of pidolate zinc per sachet) (Zabiter®, Difass, San Marino). All groups were offered ORS and diet according to ESPGHAN guidelines. Duration (in hours) of diarrhoea (up to the last loose stool) and hospitalisation, number of stools (per day), vomiting, weight gain, results of stool tests, and number of infections during follow‐up were collected through a specific form, daily during hospitalization and at 7‐14‐30‐60‐90 days from the recruitment. Results: The median number of stools and vomiting, duration of diarrhoea and hospitalization, weight gain, number of patients with Rotavirus or Salmonella infection were not significantly different among the 3 groups. Three out of 9 children from group A, 2/11 from group B and 0/12 from group C still had positive stool tests after 7 days from admission. Fewer patients from group C presented infections and recurrence of diarrhoea during both in the short term (<30 days) and long term (90 days) follow up. Median duration of vomiting was also shorter (24 hours vs. 48 hours) in groups B and C compared to the placebo group. Conclusion: Zinc supplementation does not seem to significantly reduce the duration and severity of acute diarrhoea in hospitalized Italian children. Larger studies are necessary to prove the benefit of a specific symbiotic with zinc on reducing the excretion of Rotavirus and Salmonella and the occurrence of infections.