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Meta-analysis: Smectite in the treatment of acute infectious diarrhoea in children Szajewska H; Dziechciarz P; Mrukowicz JAliment Pharmacol Ther 2006[Jan]; 23 (2): 217-27BACKGROUND: Although not currently recommended, dioctahedral smectite (smectite) is commonly used to treat acute infectious diarrhoea in many countries. AIM: To evaluate systematically the effectiveness of smectite in treating acute infectious diarrhoea in children. METHODS: Using medical subject headings and free-language terms, the following electronic databases were searched for studies relevant to acute infectious diarrhoea and smectite: MEDLINE, EMBASE, CINAHL and The Cochrane Library; additional references were obtained from reviewed articles. Only randomized-controlled trials were included. RESULTS: Nine randomized-controlled trials (1238 participants) met the inclusion criteria. Combined data from six randomized-controlled trials showed that smectite significantly reduced the duration of diarrhoea compared with placebo. The pooled weighted mean difference was (-22.7 h, 95% CI: -24.8 to -20.6) with a fixed model and remained significant in a random effect model (-24.4 h, 95% CI: -29.8 to -19.1). The chance of cure on intervention day 3 was significantly increased in the smectite vs. the control group (RR 1.64, 95% CI: 1.36-1.98; number needed to treat 4, 95% CI: 3-5). Adverse effects were similar in both groups. CONCLUSIONS: Smectite may be a useful adjunct to rehydration therapy in treating acute paediatric gastroenteritis. However, the results of this meta-analysis should be interpreted with caution as most of the included studies had important limitations. Cost-effectiveness analyses should be undertaken before routine pharmacological therapy with smectite is recommended.|Acute Disease[MESH]|Adolescent[MESH]|Antidiarrheals/adverse effects/*therapeutic use[MESH]|Child[MESH]|Child, Preschool[MESH]|Diarrhea/*drug therapy[MESH]|Feces[MESH]|Gastroenteritis/drug therapy[MESH]|Humans[MESH]|Infant[MESH]|Patient Compliance[MESH]|Randomized Controlled Trials as Topic[MESH]|Silicates/adverse effects/*therapeutic use[MESH]|Time Factors[MESH]|Treatment Outcome[MESH]|Vomiting/complications[MESH] |