This systematic review evaluates all clinical studies that cumulatively analyse how the use of probiotics, prebiotics or symbiotic have reduced the severity of gastroenteritis (GE) among children aged 0-12 years. A PRISMA based approach was done to search English language, full text articles in PUBMED/Medline and Google Scholar databases which resulted in analysis of 26 full text clinical trials. Overall, the included studies were of moderate quality. The individual studies were all prospective in nature and varied in terms of age of participants, duration of follow up and combination of probiotic/ prebiotic/ symbiotic used. Accounting for the vast heterogeneity, risk of bias across the studies, only standardized means were taken for selected studies were taken in quantitative synthesis. When mean number of hours of diarrhoea was considered, 10 of the 26 studies were included, which resulted in effect estimate of -0.49 [-0.87, -0.12] [Chi2=116.22, I2= 92%, p=0.01] and when the number of days of diarrhoea was considered only 4 studies were included with an effect estimate of 0.19 [-0.52, 0.90] [Chi2=55.46, I2=95%, p=60]. These results should be interpreted with caution considering the individual variations among the included trials. Thus, probiotic/ prebiotic/ symbiotic supplementation can be used as an adjuvant to the existing treatment protocol of oral rehydration with fluids but not as a replacement. A uniform methodological protocol for assessing
these components should be drawn in order to estimate their efficacy and their real time clinical benefits.