Gutiérrez-Castrellón P, Ortíz-Hernández AA, Llamosas-Gallardo B, Acosta-Bastidas MA, Jiménez-Gutiérrez C, Diaz-García L, Anzo-Osorio A, Estevez-Jiménez J, Jiménez-Escobar I, Vidal-Vázquez RP

Idioma: Español
Referencias bibliográficas: 88
Paginas: 329-337
Archivo PDF: 287.11 Kb.

RESUMEN

Racional del estudio: A pesar de los grandes avances en su tratamiento, la diarrea aguda continúa representando un problema de salud pública en menores de cinco años. Existe poca sistematización en el tratamiento, y la mayor parte de publicaciones establecen comparaciones del coadyuvante con placebo. Objetivo: Analizar, mediante una revisión sistemática, la evidencia sobre la eficacia comparativa de los coadyuvantes para el tratamiento de la diarrea aguda y presentar las comparaciones a través de un meta-análisis de tratamientos múltiples. Métodos: Búsqueda sistematizada en múltiples bases de datos de todos los ensayos clínicos relacionados con la utilización de racecadotrilo, smectita, Lactobacillus GG, Lactobacillus reuteri, Sacharomyces boulardii y zinc como coadyuvantes en diarrea aguda, evaluando como desenlace primario la duración de la diarrea. Estadísticamente la información se analizó a través de la estrategia de meta-análisis de tratamientos múltiples, evaluando la superioridad de cada medicamento mediante un análisis SUCRA. Resultados: Se demuestra la eficacia del racecadotrilo al compararlo con placebo y con el resto de los coadyuvantes analizados. La evaluación de la superioridad terapéutica situó al racecadotrilo en primer lugar, seguido por smectita y, después, L. reuteri. Conclusión: Desde el punto de vista de toma estratégica de decisiones en salud, el meta-análisis de tratamientos múltiples nos permite establecer la superioridad terapéutica del racecadotrilo como coadyuvante en el manejo integral de la diarrea aguda en menores de cinco años.

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