An interventional study of Probiotic (BioK+) and Placebo in Acute Diarrhea, sponsored by The Hospital for Sick Children. Terminated at 2 sites in Canada. Open to participants aged 1 Year to 17 Years. Per ClinicalTrials.gov, last updated 2018-04-18.
Sponsored by The Hospital for Sick Children · Not applicable, Interventional, and Prevention
In North America, one of the most common reasons for hospitalization in previously healthy children is for the treatment of infections with antibiotics. This study will determine if, in previously healthy children hospitalized and prescribed intravenous (IV) antibiotics, the co-administration of a probiotic milk product containing good bacteria, is safe and effective for reducing AAD, as compared to a placebo (identical appearing milk product). This will be a two-center, randomized, masked, placebo-controlled clinical trial. The results of this study will help inform clinicians and families on the use of probiotics in the prevention of AAD, a common side effect of antibiotic use among hospitalized children.
A two-centred randomized, multi-blind (i.e. patients, caregivers, data collectors, outcome assessors, data managers and analysts), placebo-controlled clinical trial intended to evaluate the efficacy and safety of Bio-K+ (Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R and Lactobacillus rhamnosus CLR2) in the prevention of AAD in hospitalized children 1 year to 17 years of age administered IV antibiotics.
852 studies on the registry are indexed under Diarrhea; 78 are open to participants now.
This study's enrollment of 16 is below the median of 136 across 713 interventional studies indexed under Diarrhea.
Browse Diarrhea studies →The Hospital for Sick Children is the lead sponsor of 568 studies on the registry; 81 are open to participants now.
Of its 7 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.
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Exclusion Criteria:
Children will receive 10-40 billion CFUs/day of Bio-K+ (Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R and Lactobacillus rhamnosus CLR2), with dose based on their weight. The product will be administered as a strawberry flavored tub of milk.
Dietary Supplement: Probiotic (BioK+)
Strawberry flavored tub of milk, identical (taste, color, odor) to the active Bio-K+ treatment.
Other: Placebo
Probiotic (BioK+) with 3 stains of Lactobacillus
Strawberry flavored tub of milk, identical (taste, color, odor) to the active Bio-K+ treatment.
Incidence of antibiotic-associated diarrhea (AAD)
The investigators will employ a questionnaire addressing Pediatric Acute Diarrhea (qPAD), a measure of diarrhea involving the assessment of stool frequency and consistency for each bowel movement. To measure consistency, the qPAD contains a stool consistency classification system. Our registered sample size is based on pilot data from The Hospital for Sick Children indicating that the incidence of AAD is 33% (95% CI 23% to 43%) according to the qPAD. Given an estimated baseline AAD risk of 32.9% and a 48% relative risk reduction in AAD (Johnston et al, Cochrane Library, 2011), a randomized trial with 80% power and a 2-sided alpha of 0.05 comparing Bio-K+ with placebo would require a total sample size of 118 patients per group (236 total).
Time frame: 2 weeks after antibiotic + probiotic completion
Incidence of antibiotic-associated diarrhea (AAD), global impression
Given that parents have knowledge of the child's typical bowel movements per day, the investigators will also employ a Global Rating Scale for diarrhea (GRSd), using a 0 to 4 scale (0 = no diarrhea, 1 = mild diarrhea, 2 = moderate diarrhea, 3 = severe diarrhea, 4 = worse imaginable diarrhea). The investigators will ask participants to select values based on diarrhea severity, which is a combination of stool frequency and consistency over 24 hours. Our registered sample size is based on the incidence of AAD (33%; 95% CI 23% to 43%) according to the qPAD. However, the incidence of AAD according to GRSd is 23%, which corresponds to the lower bound of the 95% CI for the qPAD. The investigators are currently applying for additional peer-reviewed funds. If these funds are obtained the investigators will power the trial based GRSd, a more conservative AAD incidence (23%). The investigators will also power the trial for a smaller treatment effect (39% relative risk reduction).
Time frame: 2 weeks after antibiotic + probiotic completion
Severity of AAD
The investigators will assess severity using the qPAD and the investigators will employ definitions for diarrhea from the Canadian Nosocomial Infection Surveillance Program, modified for use in children, defined as: severe: ≥6 loose/unformed/liquid stools; moderate: ≥3 loose/unformed/liquid stools; mild: a change in stooling pattern to 1-2 loose/unformed/liquid stools daily (Gravel 2007). The investigators will classify severity according to the 24-hour period with the highest degree of severity.
Time frame: 2 weeks after antibiotic completion
Adverse events
Incidence of mild (e.g. self-resolving), moderate (e.g. those that warrant medical evaluation) and serious (e.g. those that warrant continued hospitalization) adverse events based on criteria adopted by the National Institute of Health common terminology criteria for adverse events (NIH severity) will be evaluated.
Time frame: 2 weeks after antibiotic completion
Duration of AAD
The investigators will measure duration of AAD using a definition of diarrhea resolution (diarrhea offset) developed based on a systematic review of 138 trials of Pediatric Acute Diarrhea, and Delphi consensus with a panel of experts in pediatrics, clinical gastroenterology and measurement (Johnston BC et al. Pediatrics 2010; Jul;126(1):e222-31; Johnston BC et al. Symposium Probio, Quebec City, Canada, 2015). For children up to 17 years of age, acute diarrhea typically lasts less than 7 days and not longer than 14 days and resolution is marked by 1. production of 2 consecutive normal stools (i.e. "soft and formed" or "hard and formed") stool or; 2. production of one normal stool followed by 12 hours with no stool production or; 3. normal stool production (or no stool production) for a period of 24 hours.
Time frame: 2 weeks after antibiotic completion
Plan to share: Undecided — To be determined.
This study is terminated, as verified in Apr 2018. You cannot join it, but the record below documents what was studied.
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