Comparison of Zinc Plus Probiotics Therapy versus Probiotics Alone for Treatment of Acute Diarrhea in Children
DOI:
https://doi.org/10.70749/ijbr.v3i7.3034Keywords:
Acute diarrhea, probiotics, zinc, children, randomized controlled trial, recoveryAbstract
Background: Acute diarrhea is a major cause of morbidity in children under five years of age, particularly in developing countries. Objective: To compare the efficacy of zinc plus probiotics therapy versus probiotics alone in the treatment of acute diarrhea in children. Methods: This randomized controlled trial was conducted at the Department of Pediatrics, Hameed Latif Hospital, Lahore, from January 2025 to May 2025. A total of 80 children aged 3–60 months with acute diarrhea were enrolled and randomly allocated into two groups: Group ZP (zinc plus probiotics, n=40) and Group P (probiotics only, n=40). Group ZP received oral zinc (20 mg/day) for 10 days along with Bacillus clausii probiotics for 5 days, while Group P received probiotics alone. Outcomes measured included duration of diarrhea after treatment, total hospital stay, and recovery within five days. Results: The mean duration of diarrhea after treatment was significantly lower in Group ZP (28.4 ± 13.6 hours) compared to Group P (39.7 ± 18.9 hours) (p=0.004). The mean hospital stay was also shorter in Group ZP (2.6 ± 0.8 days) compared to Group P (3.3 ± 1.1 days) (p=0.002). Recovery within five days was achieved in 90.0% of children in the zinc plus probiotics group versus 72.5% in the probiotics-only group (p=0.04). Conclusion: Zinc plus probiotics therapy is more effective than probiotics alone in reducing the duration of diarrhea, shortening hospital stay, and improving recovery in children with acute diarrhea.
Downloads
References
1. Ahmadipour S, Mohsenzadeh A, Alimadadi H, Salehnia M, Fallahi A. Treating Viral Diarrhea in Children by Probiotic and Zinc Supplements. Pediatric gastroenterology, hepatology & nutrition. 2019;22(2):162-70.
https://doi.org/10.5223/pghn.2019.22.2.162
2. Ahmed Ismail M, Abdilahi MM, Abdeeq BA, Jama M. Prevalence and associated factors of acute diarrhea among under-five children living in Hargeisa Internally Displaced Persons, Somaliland: a community-based cross-sectional study. The Pan African medical journal. 2024;47:10.
https://doi.org/10.11604/pamj.2024.47.10.35958
3. Li Z, Zhu G, Li C, Lai H, Liu X, Zhang L. Which Probiotic Is the Most Effective for Treating Acute Diarrhea in Children? A Bayesian Network Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021;13(12):4319.
https://doi.org/10.3390/nu13124319
4. Huang R, Xing HY, Liu HJ, Chen ZF, Tang BB. Efficacy of probiotics in the treatment of acute diarrhea in children: a systematic review and meta-analysis of clinical trials. Translational pediatrics. 2021;10(12):3248-60.
https://doi.org/10.21037/tp-21-511
5. Hyder R, Ahmed S, Ahmed ATM. Compare the Effect of Zinc–Probiotic versus Zinc Therapy in Acute Watery Diarrhea in Children. KYAMC Journal. 2023;13:218-22.
https://doi.org/10.3329/kyamcj.v13i4.64890
6. Christi H, Tjahjono K, Syauqy A. Zinc and probiotic supplementation: effect on the frequency and duration of acute diarrhea in children under five. 2023. 2023;8(2).
https://doi.org/10.30604/jika.v8i3.2041
7. Kakar Z, Essazai AB, Ahmed SM, Ullah N, Jan P. Comparison of Zinc-Probiotic Combination Therapy to Probiotic Therapy Alone in Treating Acute Diarrhea in Children. Pakistan Journal of Medical & Health Sciences. 2022;16(12):253-.
https://doi.org/10.53350/pjmhs20221612253
8. Farhat A, Shaukat A, Sadiq N. Comparison of clinical efficacy of combined versus monotherapy of oral zinc and probiotic in pediatric acute diarrhoea at benazir bhutto shaheed teaching hospital, Abbottabad. Journal of Bahria University Medical and Dental College. 2018;8(4):210-3.
https://doi.org/10.51985/jbumdc2018061
9. Hatta M, Supriatmo S, Ali M, Sinuhaji AB, Hasibuan B, Nasution FL. Comparison of zinc-probiotic combination therapy to zinc therapy alone in reducing the severity of acute diarrhea. Paediatrica Indonesiana. 2011;51(1):1-6.
https://doi.org/10.14238/pi51.1.2011.1-6
10. Raza, W., Mahmood, T., Atta, L., Hassan, S., Ullah, S., Ali, S., ... & Ahmad, N. (2024). Comparative Effectiveness of Zinc Supplementation Combined with Probiotic Therapy Versus Zinc Alone in Reducing Acute Diarrhea Duration, Severity, and Recurrence Rates in Pediatric Populations: A Meta-Analysis. Indus Journal of Bioscience Research, 2(02), 681-689.
https://doi.org/10.70749/ijbr.v2i02.256
11. Abdulah, D. M., Sulaiman, S. J., & Ahmed, Z. W. (2024). Effect of probiotics plus zinc supplementation on clinical outcomes of infants and children with acute infectious diarrhea: a randomized controlled trial. Clinical and Experimental Pediatrics, 67(4), 203.
https://doi.org/10.3345/cep.2023.01340
12. Hassan, M. A. E. A., Younis, M. M. S., & Mohamed, H. A. E. R. (2021). Efficacy of oral zinc and probiotic on acute diarrhea in infancy. Al-Azhar J Pediatr, 24(2), 2114-29.
13. Mariam, M., Akter, M. T., Anjuman, H., Hussain, N., & Alia, R. A. (2022). A Comparative Evaluation on the Effect of Zinc-Probiotic Combination and Probiotic Therapy Alone in Paediatric Acute Diarrhoea. The Planet, 6(02), 149-163.
14. Rosyid, R. A., Arifin, F. F., & Kristanto, A. Y. (2025). Effectiveness of Zinc Therapy with Zinc-Probiotic Combination Therapy on the Duration of Diarrhea During Hospitalization at Mawaddah Medika Hospital in October-December 2023. Golden Ratio of Data in Summary, 5(2), 32-36.
https://doi.org/10.52970/grdis.v5i2.1106
15. Lahiri, K. R., Singh, R., Apte, M., Patil, M., Taksande, A., Varona, R., ... & Perez, M. I. (2022). Efficacy and safety of Bacillus clausii (O/C, N/R, SIN, T) probiotic combined with oral rehydration therapy (ORT) and zinc in acute diarrhea in children: a randomized, double-blind, placebo-controlled study in India. Tropical diseases, travel medicine and vaccines, 8(1), 9.
https://doi.org/10.1186/s40794-022-00166-6
16. Kodam, V. (2022). A comparative study of ors (oral rehydration solution) with probiotics versus ors with zinc as an adjunct therapy in pediatric acute diarrhoeal diseases. Perspec. Med. Res, 9, 26-29.
https://doi.org/10.47799/pimr.0903.07
17. Riaz, M. H. Clinical Outcome of Zinc Plus Saccharomyces Boulardii versus Zinc Alone in the Treatment of Acute Diarrhea in Children Under 5 Years of Age.
18. Rizwan, W., Tufail, M., Zafar, B., & Shah, A. A. (2025, September). Effectiveness of Zinc Supplementation with ORS and Bacillus clausii versus zinc with ORS and Saccharomyces boulardii in Acute Watery Diarrhea in Pediatric Patients. In Proceedings (Vol. 39, No. 3, pp. 114-118).
https://doi.org/10.47489/szmc.v39i3.790
19. Kayani, A. S., Asad, S., Saeed, T., & Aslam, H. (2024). Comparison Between Therapeutic Efficacy of Zinc Only and Zinc-Probiotics in Children with Acute Gastroenteritis. Mirpur Journal of Medical Sciences, 2(1), 11-14.
20. Biswas, S., & Bal, B. (2023). Comparative, randomized-controlled trial on efficacy and safety of Lactobacillus rhamnosus GG and Saccharomyces boulardii in treatment of acute diarrhea in Indian children (COMPARE-GG trial). International Journal, 10(2), 131.
https://doi.org/10.18203/2349-3259.ijct20231103
21. Ismail, M. A., Alharbi, R. F., Hakami, R. A., Alotaibi, R. M., Alhazmi, R. A., Rasain, R. A. A., ... & Albinahmed, M. A. S. (2025). Effectiveness of Probiotics in Reducing the Duration of Acute Diarrhea in Children: A Systematic Review. TPM–Testing, Psychometrics, Methodology in Applied Psychology, 32(S7 (2025): Posted 10 October), 263-271
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
