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Lactobacillus Reuteri Versus Placebo in the Treatment of Infantile Colic
This study is currently recruiting participants.
Verified by Ospedale Infantile Regina Margherita, May 2009
First Received: May 5, 2009   Last Updated: May 6, 2009   History of Changes
Sponsored by: Ospedale Infantile Regina Margherita
Information provided by: Ospedale Infantile Regina Margherita
ClinicalTrials.gov Identifier: NCT00893711
  Purpose

The purpose of this study is:

  • to study the intestinal microflora of colicky infants before and after L. reuteri or placebo administration, evaluating the effect of Lactobacillus reuteri on the growth of the main intestinal microbiota (coliforms, Clostridium butyricum, Lactobacilli, Bifidobacteria) with fluorescent in situ hybridization (FISH) technique;
  • to evaluate the improvement of colicky symptoms by the oral administration of Lactobacillus reuteri (primary outcome: reduction of the daily average crying time from baseline to the end of the treatment period, to less than 3 hours a day, the cut-off proposed by Wessel; secondary outcome: number of responders versus non-responders in each group at the end of the treatment).

Condition Intervention Phase
Infantile Colic
Infantile Functional Gastrointestinal Disorders
Other: Lactobacillus reuteri DSM 17938
Other: Placebo
Phase IV

U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Efficacy Study
Official Title: Lactobacillus Reuteri Versus Placebo in the Treatment of Infantile Colic: a Clinical and Microbiological, Double-Blind, Prospective, Randomised, Controlled Study

Further study details as provided by Ospedale Infantile Regina Margherita:

Primary Outcome Measures:
  • To evaluate the intestinal microflora of colicky infants before and after the Lactobacillus reuteri or placebo administration (coliforms, Clostridium butyricum, Lactobacilli, Bifidobacteria) with FISH technique. [ Time Frame: time 0 - 21 days ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Reduction of the daily average crying time from baseline to the end of the treatment period, to less than 3 hours a day, the cut-off proposed by Wessel and number of responders versus non-responders in each group at the end of the treatment [ Time Frame: time 0 - 7 - 21 days ] [ Designated as safety issue: No ]

Estimated Enrollment: 50
Study Start Date: March 2008
Estimated Study Completion Date: August 2009
Estimated Primary Completion Date: August 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Lactobacillus reuteri: Active Comparator
Lactobacillus reuteri DSM 17938 is administered at a dose of 1.000.000.000 colony forming units (CFU) in V drops of a commercially available oil suspension, 30 min before feeding, once a day for 21 days.
Other: Lactobacillus reuteri DSM 17938
Lactobacillus reuteri is administered at a dose of 1.000.000.000 colony forming units (CFU) in V drops/day for 21 days
Placebo: Placebo Comparator
Placebo is administered in V drops once a day for 21 days. Placebo is inactive, similar to the studied treatment with the same package, taste, characteristics of colour and consistency.
Other: Placebo
Placebo is administered in V drops once a day for 21 days. Placebo is inactive, similar to the studied treatment with the same package, taste, characteristics of colour and consistency.

Detailed Description:

Infantile colic is one of the most common problems within the first three months of life. It consists of a behavioural syndrome characterised by paroxysmal, excessive and inconsolable crying without identifiable cause. Although infantile colic is commonly reported and causes appreciable distress for both parents and paediatricians, despite forty years of research, its aetiology still remains unclear. Recently the role of intestinal microflora has growing importance, and a lower count of intestinal lactobacilli has been observed in colicky infants compared to healthy ones. In a recent study we have observed that Lactobacillus reuteri improved colicky symptoms in breast-fed infants within one week of treatment compared to Simethicone, suggesting that probiotics may play a role in infantile colic (Savino F, Pelle E, Palumeri E, Oggero R, Miniero R.Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics 2007; 119:e124-30). The mechanism involved in such finding is only partially understood and, for this reason, we have planned this new study to evaluate not only the clinical improvement but also the microbiological data.

  Eligibility

Ages Eligible for Study:   up to 16 Weeks
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • clinical diagnosis of infantile colic according to Wessel's criteria
  • gestational age between 37 and 42 weeks
  • age between 4 and 16 weeks
  • birth weight between 2500 and 4000 g
  • exclusively breastfed

Exclusion Criteria:

  • clinical evidence of chronic illness or gastrointestinal disorders
  • administration of probiotics and antibiotics
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00893711

Contacts
Contact: Francesco Savino, MD, PhD 00390113135618 francesco.savino@unito.it

Locations
Italy, Torino
Ospedale Infantile Regina Margherita Recruiting
Piazza polonia 94 - Torino, Torino, Italy, 10126
Contact: Valentina Tarasco, MD     00390113135257     valentina.tarasco@libero.it    
Sub-Investigator: Valentina Tarasco, MD            
Sub-Investigator: Elisabetta Palumeri, MD            
Sub-Investigator: Emanuela Locatelli, MD            
Sub-Investigator: Diego Matteuzzi, Professor            
Sub-Investigator: Lisa Cordisco, PhD            
Sub-Investigator: Roberto Oggero, MD            
Sub-Investigator: Emanuele Castagno, MD            
Sub-Investigator: Roberto Calabrese, PhD            
Sponsors and Collaborators
Ospedale Infantile Regina Margherita
Investigators
Principal Investigator: Francesco Savino, MD, PhD Ospedale Infantile Regina Margherita - Dipartimento di scienze Pediatriche e dell'Adolescenza
  More Information

Publications:
Savino F. Focus on infantile colic. Acta Paediatr. 2007 Sep;96(9):1259-64. Review.
Savino F, Pelle E, Castagno E, Palumeri E, Oggero R. Must infants with colic really be hospitalized? Acta Paediatr. 2007 Jul;96(7):1109; author reply 1110. Epub 2007 May 10. No abstract available.
Savino F, Pelle E, Palumeri E, Oggero R, Miniero R. Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics. 2007 Jan;119(1):e124-30.
Savino F, Grassino EC, Guidi C, Oggero R, Silvestro L, Miniero R. Ghrelin and motilin concentration in colicky infants. Acta Paediatr. 2006 Jun;95(6):738-41.
Savino F, Palumeri E, Castagno E, Cresi F, Dalmasso P, Cavallo F, Oggero R. Reduction of crying episodes owing to infantile colic: A randomized controlled study on the efficacy of a new infant formula. Eur J Clin Nutr. 2006 Nov;60(11):1304-10. Epub 2006 May 31.
Savino F, Castagno E, Bretto R, Brondello C, Palumeri E, Oggero R. A prospective 10-year study on children who had severe infantile colic. Acta Paediatr Suppl. 2005 Oct;94(449):129-32.
Savino F, Cresi F, Castagno E, Silvestro L, Oggero R. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants. Phytother Res. 2005 Apr;19(4):335-40.
Savino F, Bailo E, Oggero R, Tullio V, Roana J, Carlone N, Cuffini AM, Silvestro L. Bacterial counts of intestinal Lactobacillus species in infants with colic. Pediatr Allergy Immunol. 2005 Feb;16(1):72-5.
Savino F, Cresi F, Pautasso S, Palumeri E, Tullio V, Roana J, Silvestro L, Oggero R. Intestinal microflora in breastfed colicky and non-colicky infants. Acta Paediatr. 2004 Jun;93(6):825-9.

Responsible Party: Ospedale Infantile Regina Margherita - Dipartimento di Scienze Pediatriche ( Savino Francesco MD PhD )
Study ID Numbers: FS-2009
Study First Received: May 5, 2009
Last Updated: May 6, 2009
ClinicalTrials.gov Identifier: NCT00893711     History of Changes
Health Authority: Italy: Ethics Committee

Keywords provided by Ospedale Infantile Regina Margherita:
infantile colic
lactobacillus
gut microflora
FISH

Study placed in the following topic categories:
Signs and Symptoms
Digestive System Diseases
Signs and Symptoms, Digestive
Abdominal Pain
Gastrointestinal Diseases
Colic
Pain

Additional relevant MeSH terms:
Signs and Symptoms
Digestive System Diseases
Signs and Symptoms, Digestive
Abdominal Pain
Gastrointestinal Diseases
Colic
Pain

ClinicalTrials.gov processed this record on May 07, 2009