The efficacy of bismuth subsalicylate in the treatment of acute diarrhoea and the prevention of persistent diarrhoea

Acta Paediatr. 2001 Jun;90(6):605-10.


A controlled, randomized, double-blind study in Bangladeshi children (ages 4-36 mo) with acute diarrhoea was undertaken to determine whether bismuth subsalicylate (BSS) would prevent the development of persistent diarrhoea (PD) in young children. The children were randomized to two groups: 226 were given liquid oral BSS, (as Pepto-Bismol), 100 mg/kg/d for 5 d; 225 were given placebo of identical appearance. On admission to the study, the two groups were comparable both clinically and microbiologically. Rotavirus was found in 56% of all the children, and enterotoxigenic E. coli in 31% of a subsample studied. Children treated with BSS had less severe and less prolonged illness than those treated with placebo (p = 0.057). There was, however, no difference in the development of PD between the two groups (8% and 11%). Unexpectedly, patients treated with BSS gained significantly more weight (2.3%) than those treated with placebo (0.5%; p < 0.001) during the course of the study. No toxicity of BSS was detected.

Conclusion: Treatment with BSS had a modest therapeutic effect on acute diarrhoea, as has been previously demonstrated, but with no suggestion of a therapeutic effect on the prevention of persistent diarrhoea in this group of patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Bismuth / therapeutic use*
  • Child, Preschool
  • Diarrhea / drug therapy*
  • Diarrhea / prevention & control
  • Double-Blind Method
  • Escherichia coli Infections
  • Humans
  • Infant
  • Organometallic Compounds / therapeutic use*
  • Rehydration Solutions / therapeutic use*
  • Retroviridae Infections / drug therapy
  • Salicylates / therapeutic use*


  • Organometallic Compounds
  • Rehydration Solutions
  • Salicylates
  • bismuth subsalicylate
  • Bismuth