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Probiotics for prevention and treatment of respiratory tract infections in children: A systematic review and meta-analysis of randomized controlled trials.

Wang Y, Li X, Ge T, Xiao Y, Liao Y, Cui Y, Zhang Y, Ho W, Yu G, Zhang T - Medicine (Baltimore) (2016)

Bottom Line: The results of meta-analysis showed that probiotic consumption significantly decreased the number of subjects having at least 1 RTI episode (17 RCTs, 4513 children, relative risk 0.89, 95% CI 0.82-0.96, P = 0.004).However, there was no statistically significant difference of illness episode duration between probiotic intervention group and placebo group (9 RCTs, 2817 children, MD -0.60, 95% CI -1.49 to 0.30, P = 0.19).Based on the available data and taking into account the safety profile of RCTs, probiotic consumption appears to be a feasible way to decrease the incidence of RTIs in children.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Gastroenterology, Hepatology, and Nutrition bPediatric Intensive Care Unit, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China cDepartment of Pathology and Laboratory Medicine, Temple University School of Medicine, Philadelphia, PA dDepartment of Children's Healthcare, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.

ABSTRACT

Background: Respiratory tract infections (RTIs) represent one of the main health problems in children. Probiotics are viable bacteria that colonize the intestine and affect the host intestinal microbial balance. Accumulating evidence suggests that probiotic consumption may decrease the incidence of or modify RTIs. The authors systematically reviewed data from randomized controlled trials (RCTs) to investigate the effect of probiotic consumption on RTIs in children.

Methods: MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science were systematically searched for RCTs regarding the effect of probiotics on RTIs in children. The outcomes included number of children experienced with at least 1 RTI episode, duration of illness episodes, days of illness per subject, and school/day care absenteeism due to infection. A random-effects model was used to calculate pooled relative risks, or mean difference (MD) with the corresponding 95% confidence interval (CI).

Results: A total of 23 trials involving 6269 children were eligible for inclusion in the systematic review. None of the trials showed a high risk of bias. The quality of the evidence of outcomes was moderate. The age range of subjects was from newborn to 18 years. The results of meta-analysis showed that probiotic consumption significantly decreased the number of subjects having at least 1 RTI episode (17 RCTs, 4513 children, relative risk 0.89, 95% CI 0.82-0.96, P = 0.004). Children supplemented with probiotics had fewer numbers of days of RTIs per person compared with children who had taken a placebo (6 RCTs, 2067 children, MD -0.16, 95% CI -0.29 to 0.02, P = 0.03), and had fewer numbers of days absent from day care/school (8 RCTs, 1499 children, MD -0.94, 95% CI -1.72 to -0.15, P = 0.02). However, there was no statistically significant difference of illness episode duration between probiotic intervention group and placebo group (9 RCTs, 2817 children, MD -0.60, 95% CI -1.49 to 0.30, P = 0.19).

Conclusion: Based on the available data and taking into account the safety profile of RCTs, probiotic consumption appears to be a feasible way to decrease the incidence of RTIs in children.

No MeSH data available.


Related in: MedlinePlus

Effect of probiotics on the number of subjects who had at least 1 RTI episode. The “total” is the number of subjects included in the analysis in probiotics and placebo group. CI = confidence interval, M-H = mantel-haenszel, RTI = respiratory tract infection.
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Figure 2: Effect of probiotics on the number of subjects who had at least 1 RTI episode. The “total” is the number of subjects included in the analysis in probiotics and placebo group. CI = confidence interval, M-H = mantel-haenszel, RTI = respiratory tract infection.

Mentions: Seventeen trials[34–44,48–50,52–54] including 4513 children reported that the number of subjects had at least 1 respiratory symptom episode during the study period. As shown in Fig. 2, probiotic supplementation had a significant effect on the reduction of number of subjects having at least 1 respiratory symptom episode (relative risk 0.89, 95% CI 0.82–0.96, P = 0.004). However, there was a statistical heterogeneity among these trials (τ2 = 0.02, P < 0.00001, I2 = 82%).


Probiotics for prevention and treatment of respiratory tract infections in children: A systematic review and meta-analysis of randomized controlled trials.

Wang Y, Li X, Ge T, Xiao Y, Liao Y, Cui Y, Zhang Y, Ho W, Yu G, Zhang T - Medicine (Baltimore) (2016)

Effect of probiotics on the number of subjects who had at least 1 RTI episode. The “total” is the number of subjects included in the analysis in probiotics and placebo group. CI = confidence interval, M-H = mantel-haenszel, RTI = respiratory tract infection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979858&req=5

Figure 2: Effect of probiotics on the number of subjects who had at least 1 RTI episode. The “total” is the number of subjects included in the analysis in probiotics and placebo group. CI = confidence interval, M-H = mantel-haenszel, RTI = respiratory tract infection.
Mentions: Seventeen trials[34–44,48–50,52–54] including 4513 children reported that the number of subjects had at least 1 respiratory symptom episode during the study period. As shown in Fig. 2, probiotic supplementation had a significant effect on the reduction of number of subjects having at least 1 respiratory symptom episode (relative risk 0.89, 95% CI 0.82–0.96, P = 0.004). However, there was a statistical heterogeneity among these trials (τ2 = 0.02, P < 0.00001, I2 = 82%).

Bottom Line: The results of meta-analysis showed that probiotic consumption significantly decreased the number of subjects having at least 1 RTI episode (17 RCTs, 4513 children, relative risk 0.89, 95% CI 0.82-0.96, P = 0.004).However, there was no statistically significant difference of illness episode duration between probiotic intervention group and placebo group (9 RCTs, 2817 children, MD -0.60, 95% CI -1.49 to 0.30, P = 0.19).Based on the available data and taking into account the safety profile of RCTs, probiotic consumption appears to be a feasible way to decrease the incidence of RTIs in children.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Gastroenterology, Hepatology, and Nutrition bPediatric Intensive Care Unit, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China cDepartment of Pathology and Laboratory Medicine, Temple University School of Medicine, Philadelphia, PA dDepartment of Children's Healthcare, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, PR China.

ABSTRACT

Background: Respiratory tract infections (RTIs) represent one of the main health problems in children. Probiotics are viable bacteria that colonize the intestine and affect the host intestinal microbial balance. Accumulating evidence suggests that probiotic consumption may decrease the incidence of or modify RTIs. The authors systematically reviewed data from randomized controlled trials (RCTs) to investigate the effect of probiotic consumption on RTIs in children.

Methods: MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science were systematically searched for RCTs regarding the effect of probiotics on RTIs in children. The outcomes included number of children experienced with at least 1 RTI episode, duration of illness episodes, days of illness per subject, and school/day care absenteeism due to infection. A random-effects model was used to calculate pooled relative risks, or mean difference (MD) with the corresponding 95% confidence interval (CI).

Results: A total of 23 trials involving 6269 children were eligible for inclusion in the systematic review. None of the trials showed a high risk of bias. The quality of the evidence of outcomes was moderate. The age range of subjects was from newborn to 18 years. The results of meta-analysis showed that probiotic consumption significantly decreased the number of subjects having at least 1 RTI episode (17 RCTs, 4513 children, relative risk 0.89, 95% CI 0.82-0.96, P = 0.004). Children supplemented with probiotics had fewer numbers of days of RTIs per person compared with children who had taken a placebo (6 RCTs, 2067 children, MD -0.16, 95% CI -0.29 to 0.02, P = 0.03), and had fewer numbers of days absent from day care/school (8 RCTs, 1499 children, MD -0.94, 95% CI -1.72 to -0.15, P = 0.02). However, there was no statistically significant difference of illness episode duration between probiotic intervention group and placebo group (9 RCTs, 2817 children, MD -0.60, 95% CI -1.49 to 0.30, P = 0.19).

Conclusion: Based on the available data and taking into account the safety profile of RCTs, probiotic consumption appears to be a feasible way to decrease the incidence of RTIs in children.

No MeSH data available.


Related in: MedlinePlus