{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:31:42Z","timestamp":1791901902055,"version":"4.3.4"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD071915"],"award-info":[{"award-number":["R01HD071915"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Pediatric Emergency Care Applied Research Network","award":["U03MC00001"],"award-info":[{"award-number":["U03MC00001"]}]},{"name":"Pediatric Emergency Care Applied Research Network","award":["U03MC00003"],"award-info":[{"award-number":["U03MC00003"]}]},{"name":"Pediatric Emergency Care Applied Research Network","award":["U03MC00006"],"award-info":[{"award-number":["U03MC00006"]}]},{"name":"Pediatric Emergency Care Applied Research Network","award":["U03MC00007"],"award-info":[{"award-number":["U03MC00007"]}]},{"name":"Pediatric Emergency Care Applied Research Network","award":["U03MC00008"],"award-info":[{"award-number":["U03MC00008"]}]},{"name":"Pediatric Emergency Care Applied Research Network","award":["U03MC22684"],"award-info":[{"award-number":["U03MC22684"]}]},{"name":"Pediatric Emergency Care Applied Research Network","award":["U03MC22685"],"award-info":[{"award-number":["U03MC22685"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30DK052574"],"award-info":[{"award-number":["P30DK052574"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["286384"],"award-info":[{"award-number":["286384"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["325412"],"award-info":[{"award-number":["325412"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>It is unknown if probiotics exert pathogen-specific effects in children with diarrhea secondary to acute gastroenteritis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Analysis of patient-level data from 2 multicenter randomized, placebo controlled trials conducted in pediatric emergency departments in Canada and the United States. Participants were 3\u201348 months with &amp;gt;3 diarrheal episodes in the preceding 24 hours and were symptomatic for &amp;lt;72 hours and &amp;lt;7 days in the Canadian and US studies, respectively. Participants received either placebo or a probiotic preparation (Canada-Lactobacillus rhamnosus R0011\/Lactobacillus helveticus R0052; US-L. rhamnosus GG). The primary outcome was post-intervention moderate-to-severe disease (ie, \u22659 on the Modified Vesikari Scale [MVS] score).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Pathogens were identified in specimens from 59.3% of children (928\/1565). No pathogen groups were less likely to experience an MVS score \u22659 based on treatment allocation (test for interaction\u00a0=\u00a00.35). No differences between groups were identified for adenovirus (adjusted relative risk [aRR]: 1.42; 95% confidence interval [CI]: .62, 3.23), norovirus (aRR: 0.98; 95% CI: .56, 1.74), rotavirus (aRR: 0.86; 95% CI: .43, 1.71) or bacteria (aRR: 1.19; 95% CI: .41, 3.43). At pathogen-group and among individual pathogens there were no differences in diarrhea duration or the total number of diarrheal stools between treatment groups, regardless of intervention allocation or among probiotic sub-groups. Among adenovirus-infected children, those administered the L. rhamnosus R0011\/L. helveticus R0052 product experienced fewer diarrheal episodes (aRR: 0.65; 95% CI: .47, .90).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Neither probiotic product resulted in less severe disease compared to placebo across a range of the most common etiologic pathogens. The preponderance of evidence does not support the notion that there are pathogen specific benefits associated with probiotic use in children with acute gastroenteritis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration<\/jats:title>\n                  <jats:p>NCT01773967 and NCT01853124.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciab876","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T15:31:22Z","timestamp":1633015882000},"page":"55-64","source":"Crossref","is-referenced-by-count":15,"title":["Pathogen-Specific Effects of Probiotics in Children With Acute Gastroenteritis Seeking Emergency Care: A Randomized Trial"],"prefix":"10.1093","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2319-6192","authenticated-orcid":false,"given":"Stephen B","family":"Freedman","sequence":"first","affiliation":[{"name":"Sections of Pediatric Emergency Medicine and Gastroenterology, Alberta Children\u2019s Hospital, Alberta Children\u2019s Hospital Research Institute, Cumming School of Medicine, University of Calgary , Calgary , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaron","family":"Finkelstein","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao Li","family":"Pang","sequence":"additional","affiliation":[{"name":"Alberta Precision Laboratories-Public Health Laboratory , Alberta , Canada"},{"name":"Department of Laboratory Medicine and Pathology, University of Alberta , Edmonton, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Chui","sequence":"additional","affiliation":[{"name":"Alberta Precision Laboratories-Public Health Laboratory , Alberta , Canada"},{"name":"Department of Laboratory Medicine and Pathology, University of Alberta , Edmonton, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4078-7517","authenticated-orcid":false,"given":"Phillip I","family":"Tarr","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Washington University in St. Louis School of Medicine , St. Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"VanBuren","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah , Salt Lake City, Utah , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cody","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah , Salt Lake City, Utah , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonita E","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Women and Children\u2019s Health Research Institute , Edmonton, Alberta , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla A","family":"Hall-Moore","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Washington University in St. Louis School of Medicine , St. Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Sapien","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of New Mexico Health Sciences Center , Albuquerque, New Mexico , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"O\u2019Connell","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Emergency Medicine, The George Washington University School of Medicine and Health Sciences, Division of Emergency Medicine, Children\u2019s National Hospital , Washington D.C. , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam C","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Rhode Island Hospital\/Hasbro Children\u2019s Hospital and Brown University , Providence, Rhode Island , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Poonai","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics, Internal Medicine, Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry , London, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Roskind","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Columbia University Medical Center , New York, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Schuh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Rogers","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine and Pediatrics. Michigan Medicine, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Cincinnati Children\u2019s Hospital Medical Center and Department of Pediatrics University of Cincinnati College of Medicine , Cincinnati, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge","family":"Gouin","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Emergency Medicine & Pediatrics, Universit\u00e9 de Montr\u00e9al , Montr\u00e9al, Quebec , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and Pediatrics, University of Michigan , Ann Arbor, Michigan , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Vance","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine and Pediatrics, UC Davis, School of Medicine , Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Hurley","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, IWK Health, Dalhousie University , Halifax, Nova Scotia , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth C","family":"Powell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Emergency Medicine, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern University Feinberg School of Medicine , Chicago, Illinois , USA and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken J","family":"Farion","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Emergency Medicine, University of Ottawa , Ottawa , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schnadower","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Cincinnati Children\u2019s Hospital Medical Center and Department of Pediatrics University of Cincinnati College of Medicine , Cincinnati, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"key":"2022082503015877600_CIT0001","first-page":"170","article-title":"Probiotics for gastrointestinal conditions: a summary of the evidence","volume":"96","author":"Wilkins","year":"2017","journal-title":"Am Fam Physician"},{"key":"2022082503015877600_CIT0002","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1111\/apt.15267","article-title":"Systematic review with meta-analysis: Lactobacillus rhamnosus GG for treating acute gastroenteritis in children: a 2019 update","volume":"49","author":"Szajewska","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"2022082503015877600_CIT0003","doi-asserted-by":"crossref","first-page":"S37","DOI":"10.1097\/MCG.0000000000000349","article-title":"Probiotics for prevention and treatment of diarrhea","volume":"49 Suppl 1","author":"Guarino","year":"2015","journal-title":"J Clin Gastroenterol"},{"key":"2022082503015877600_CIT0004","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1056\/NEJMoa1802597","article-title":"Multicenter trial of a combination probiotic for children with gastroenteritis","volume":"379","author":"Freedman","year":"2018","journal-title":"N Engl J Med"},{"key":"2022082503015877600_CIT0005","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1056\/NEJMoa1802598","article-title":"Lactobacillus rhamnosus GG versus placebo for acute gastroenteritis in children","volume":"379","author":"Schnadower","year":"2018","journal-title":"N Engl J Med"},{"key":"2022082503015877600_CIT0006","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1053\/j.gastro.2020.05.059","article-title":"AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders","volume":"159","author":"Su","year":"2020","journal-title":"Gastroenterology"},{"key":"2022082503015877600_CIT0007","doi-asserted-by":"crossref","first-page":"2632","DOI":"10.1053\/j.gastro.2020.08.066","article-title":"Downgrading certainty in evidence for probiotic medicine is partially incorrect","volume":"160","author":"Koch","year":"2021","journal-title":"Gastroenterology"},{"key":"2022082503015877600_CIT0008","first-page":"73","article-title":"Norovirus and other viral causes of medically attended acute gastroenteritis across the age spectrum: results from the MAAGE study in the United States","author":"Burke","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2022082503015877600_CIT0009","doi-asserted-by":"crossref","first-page":"4999","DOI":"10.3748\/wjg.v25.i33.4999","article-title":"Efficacy of Lactobacillus rhamnosus GG in treatment of acute pediatric diarrhea: a systematic review with meta-analysis","volume":"25","author":"Li","year":"2019","journal-title":"World J Gastroenterol"},{"key":"2022082503015877600_CIT0010","first-page":"CD003048","article-title":"Probiotics for treating acute infectious diarrhoea","volume":"12","author":"Collinson","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"2022082503015877600_CIT0011","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1001\/jama.2016.12103","article-title":"Getting pharmacogenomics into the clinic","volume":"316","author":"Abbasi","year":"2016","journal-title":"JAMA"},{"key":"2022082503015877600_CIT0012","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1038\/s41591-019-0439-x","article-title":"The pros, cons, and many unknowns of probiotics","volume":"25","author":"Suez","year":"2019","journal-title":"Nat Med"},{"key":"2022082503015877600_CIT0013","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/S2468-1253(17)30160-7","article-title":"Enteropathogen detection in children with diarrhoea, or vomiting, or both, comparing rectal flocked swabs with stool specimens: an outpatient cohort study","volume":"2","author":"Freedman","year":"2017","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2022082503015877600_CIT0014","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1186\/1745-6215-15-170","article-title":"Impact of emergency department probiotic treatment of pediatric gastroenteritis: study protocol for the PROGUT (Probiotic Regimen for Outpatient Gastroenteritis Utility of Treatment) randomized controlled trial","volume":"15","author":"Freedman","year":"2014","journal-title":"Trials"},{"key":"2022082503015877600_CIT0015","doi-asserted-by":"crossref","first-page":"e018115","DOI":"10.1136\/bmjopen-2017-018115","article-title":"Randomised controlled trial of Lactobacillus rhamnosus (LGG) versus placebo in children presenting to the emergency department with acute gastroenteritis: the PECARN probiotic study protocol","volume":"7","author":"Schnadower","year":"2017","journal-title":"BMJ Open"},{"key":"2022082503015877600_CIT0016","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1097\/PEC.0b013e31826cad9f","article-title":"The effect of Lactobacillus GG on acute diarrheal illness in the pediatric emergency department","volume":"28","author":"Nixon","year":"2012","journal-title":"Pediatr Emerg Care"},{"key":"2022082503015877600_CIT0017","doi-asserted-by":"crossref","first-page":"e1278","DOI":"10.1542\/peds.2009-3270","article-title":"Evaluation of a gastroenteritis severity score for use in outpatient settings","volume":"125","author":"Freedman","year":"2010","journal-title":"Pediatrics"},{"key":"2022082503015877600_CIT0018","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/MPG.0b013e31829ae5a3","article-title":"Validation of the modified Vesikari score in children with gastroenteritis in 5 US emergency departments","volume":"57","author":"Schnadower","year":"2013","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2022082503015877600_CIT0019","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1099\/jmm.0.074773-0","article-title":"Evaluation of the Luminex xTAG Gastrointestinal Pathogen Panel and the Savyon Diagnostics Gastrointestinal Infection Panel for the detection of enteric pathogens in clinical samples","volume":"63","author":"Perry","year":"2014","journal-title":"J Med Microbiol"},{"key":"2022082503015877600_CIT0020","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/INF.0000000000001008","article-title":"Clinical significance of Clostridium difficile in children less than 2 years old: a case-control study","volume":"35","author":"Gonz\u00e1lez-Del Vecchio","year":"2016","journal-title":"Pediatr Infect Dis J"},{"key":"2022082503015877600_CIT0021","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/1745-6215-15-139","article-title":"The risks and rewards of covariate adjustment in randomized trials: an assessment of 12 outcomes from 8 studies","volume":"15","author":"Kahan","year":"2014","journal-title":"Trials"},{"key":"2022082503015877600_CIT0022","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.jpeds.2004.05.035","article-title":"Development of a clinical dehydration scale for use in children between 1 and 36 months of age","volume":"145","author":"Friedman","year":"2004","journal-title":"J Pediatr"},{"key":"2022082503015877600_CIT0023","doi-asserted-by":"crossref","DOI":"10.1002\/9780470316696","volume-title":"Multiple imputation for nonresponse in surveys","author":"Rubin","year":"1987"},{"key":"2022082503015877600_CIT0024","first-page":"187","article-title":"Efficacy of probiotic use in acute rotavirus diarrhea in children: a systematic review and meta-analysis","volume":"6","author":"Ahmadi","year":"2015","journal-title":"Caspian J Intern Med"},{"key":"2022082503015877600_CIT0025","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1080\/16070658.2018.1449378","article-title":"Efficacy and safety of Saccharomyces boulardii in the treatment of acute gastroenteritis in the paediatric population: a systematic review","volume":"32","author":"Padayachee","year":"2019","journal-title":"South Afr J Clin Nutr"},{"key":"2022082503015877600_CIT0026","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/INF.0000000000001712","article-title":"A double-blind, randomized, placebo-controlled trial of Lactobacillus acidophilus for the treatment of acute watery diarrhea in Vietnamese children","volume":"37","author":"Hong Chau","year":"2018","journal-title":"Pediatr Infect Dis J"},{"key":"2022082503015877600_CIT0027","doi-asserted-by":"crossref","first-page":"2533","DOI":"10.1038\/s41467-020-16308-3","article-title":"A randomized trial evaluating virus-specific effects of a combination probiotic in children with acute gastroenteritis","volume":"11","author":"Freedman","year":"2020","journal-title":"Nat Commun"},{"key":"2022082503015877600_CIT0028","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1093\/ajcn\/nqaa369","article-title":"Probiotic stool secretory immunoglobulin A modulation in children with gastroenteritis: a randomized clinical trial","volume":"113","author":"Freedman","year":"2021","journal-title":"Am J Clin Nutr"},{"key":"2022082503015877600_CIT0029","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1016\/j.cmi.2019.07.021","article-title":"Enteropathogens in paediatric gastroenteritis: comparison of routine diagnostic and molecular methods","volume":"25","author":"Tilmanne","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"2022082503015877600_CIT0030","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1093\/jpids\/piw083","article-title":"Case-control assessment of the roles of noroviruses, human bocaviruses 2, 3, and 4, and novel polyomaviruses and astroviruses in acute childhood diarrhea","volume":"6","author":"Melamed","year":"2017","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2022082503015877600_CIT0031","first-page":"690","article-title":"Viral gastroenteritis","volume":"45","author":"Desselberger","year":"2017","journal-title":"Medicine (Abingdon)"},{"key":"2022082503015877600_CIT0032","doi-asserted-by":"crossref","first-page":"560","DOI":"10.3201\/eid2702.203943","article-title":"Non-norovirus viral gastroenteritis outbreaks reported to the national outbreak reporting system, USA, 2009\u20132018","volume":"27","author":"Mattison","year":"2021","journal-title":"Emerg Infect Dis"},{"key":"2022082503015877600_CIT0033","first-page":"Cd004827","article-title":"Probiotics for the prevention of pediatric antibiotic-associated diarrhea","volume":"4","author":"Guo","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2022082503015877600_CIT0034","doi-asserted-by":"crossref","first-page":"e36","DOI":"10.1056\/NEJMc1900909","article-title":"Lactobacillus for gastroenteritis in children","volume":"380","author":"Berni Canani","year":"2019","journal-title":"N Engl J Med"},{"key":"2022082503015877600_CIT0035","doi-asserted-by":"crossref","first-page":"e36","DOI":"10.1056\/NEJMc1900909","article-title":"Lactobacillus for gastroenteritis in children","volume":"380","author":"Alvarez-Calatayud","year":"2019","journal-title":"N Engl J Med"},{"key":"2022082503015877600_CIT0036","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.14309\/ajg.0000000000001295","article-title":"Association between diarrhea duration and severity and probiotic efficacy in children with acute gastroenteritis","volume":"116","author":"Schnadower","year":"2021","journal-title":"Am J Gastroenterol"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciab876\/42273814\/ciab876.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/1\/55\/45513777\/ciab876.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/1\/55\/45513777\/ciab876.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T03:04:38Z","timestamp":1661396678000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/75\/1\/55\/6378775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,1]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,10,1]]},"published-print":{"date-parts":[[2022,8,24]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciab876","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,7,1]]},"published":{"date-parts":[[2021,10,1]]}}}