Antidiarrheal Properties of the Combination of Tannin Albuminate and Ethacridine Lactate - A Narrative Review

Abstract

Objective: To review the efficacy and safety of tannin albuminate and ethacridine lactate monohydrate in the treatment and prevention of diarrhea. Design: Narrative review. Data sources: A systematic literature search was conducted in MEDLINE and Embase from inception to September 2022. The search was restricted to English and German language publications. Eligibility criteria for selecting studies: Randomized controlled trials, non-interventional studies, and meta-analyses assessing tannin and/or ethacridine for the treatment or prevention of diarrhea. Results: Of 366 titles identified, a total of 13 studies were included in this review. Five randomized controlled trials and four noninterventional trials demonstrate the efficacy and safety of the fixed combination of tannin albuminate and ethacridine lactate monohydrate in treating acute diarrhea and preventing traveler's diarrhea. The fixed combination reduced acute diarrhea duration by improving stool frequency, consistency, and weight and reduced the risk of traveler's diarrhea. Two pilot studies indicate efficacy in chronic diarrhea. Safety and tolerability were very good in all included studies. Two meta-analyses investigated the efficacy of gelatin tannate in children with acute gastroenteritis. Conclusion: The efficacy and safety of tannin albuminate and ethacridine lactate monohydrate for the treatment of acute diarrhea and the prevention of traveler's diarrhea are proven in randomized controlled trials. Several noninterventional studies substantiate the real-world effectiveness and tolerability of the fixed combination. Both active ingredients combine antidiarrheal, antimicrobial, mucosal protection, and spasmolytic properties. However, existing clinical data should be updated with larger, well-designed, placebo-controlled trials in adult and pediatric patient populations.