reuteri DSM 17938 is effective for infant colic, and it will also

reuteri DSM 17938 is effective for infant colic, and it will also determine whether certain subgroups of infants would selleck Tofacitinib benefit

from it. As the effects of probiotics are strain specific,33 this IPDMA will only include the most commonly studied probiotic strain used for the management of infant colic, and will form the protocol basis for further IPDMAs involving other probiotic strains for the management or prevention of infant colic. The aims of this IPDMA are: To determine whether the probiotic L. reuteri DSM 17398 is effective in the management of infant colic; To determine whether the effects of L. reuteri DSM 17398 on infants with colic differ according to Type of feeding (exclusively breast fed vs partially breast fed vs exclusively formula fed); Proton

pump inhibitor exposure; Hypoallergenic formula exposure for formula-fed infants; Maternal dairy elimination diets for breastfed infants. Methods and analysis Search methods for identification of studies We will search for completed and ongoing randomised controlled trials by identification of published papers and protocols through the online databases MEDLINE, EMBASE, CINAHL, Database of Abstracts of Reviews of Effects (DARE), Cochrane Central Register for Controlled Trials (CENTRAL), and clinical trial registries (eg, metaRegister of Controlled Trials). Reference lists from articles will be explored to identify other potential trials. We will also perform internet searches for non-peer-reviewed articles, media articles and other relevant publications using Google, and approach presenters at relevant conferences and meetings. This IPDMA will be undertaken according to the methods recommended by the Cochrane Collaboration,34 with reporting following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.35 Eligibility criteria for included RCTs The IPDMA will include registered randomised controlled trials of the probiotic L. reuteri DSM 17398 versus

placebo, delivered orally to infants with modified Wessel’s definition of infant colic (crying for more than 3 h of the day, for more than 3 days of the week, for at least 1 week, as recorded by diaries, questionnaires or parental interviews). Studies evaluating L. reuteri ATCC 55730, the mother strain of L. reuteri DSM 17938, will be excluded. L. reuteri ATCC 55730 was found to carry potentially Brefeldin_A transferable resistance traits for tetracycline and lincomycin. Hence, it was replaced by L. reuteri DSM 17938, a strain without unwanted plasmid-borne resistance.36 It remains a matter of debate whether or not L. reuteri DSM 17938, the strain with antibiotic resistance plasmids removed, and the original L. reuteri ATCC 55730 strain can be regarded as equal. Moreover, only L. reuteri DSM 17938 is commercially available. All authors of eligible trials have been contacted and invited to participate in this IPDMA.

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