Randomized Trial of Probiotics and Calcium on Diarrhea and Respiratory Tract Infections in Indonesian Children

Pediatrics, 05/10/2012

Agustina R et al. – RC milk, alone or with L casei, did not reduce diarrhea or acute respiratory tract infections (ARTIs) in Indonesian children. L reuteri may prevent diarrhea, especially in children with lower nutritional status.


  • The authors conducted a 6-month, double-blind, placebo-controlled study in 494 healthy children aged 1 to 6 years who received low-lactose milk with low calcium content, regular calcium content, RC with 5.108 colony-forming units per day of Lactobacillus casei CRL431, or RC with 5.108 colony-forming units per day of Lactobacillus reuteri DSM17938.
  • Number and duration of diarrhea and ARTIs episodes were primary and secondary outcomes, respectively.


  • Incidence of World Health Organization–defined diarrhea (>3 loose/liquid stools in 24 hours) was not significantly different between RC and LC (relative risk [RR]: 0.99 [95% confidence interval (CI): 0.62–1.58]), between casei and RC (RR: 1.21 [95% CI: 0.76–1.92]), or between reuteri and RC (RR: 0.76 [95% CI: 0.46–1.25]) groups.
  • Incidence of all reported diarrhea was significantly lower in the reuteri versus RC group (RR: 0.68 [95% CI: 0.46–0.99]).
  • Irrespective of the definition used, reuteri significantly reduced diarrhea incidence in children with lower nutritional status (below-median height-and-weight-for-age z score).

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