Probiotics for prevention and treatment of respiratory tract infections in children

Wang, Yizhong; Li, Xiaolu; Ge, Ting; Xiao, Yongmei; Liao, Yang; Cui, Yun; Zhang, Yucai; Ho, Wen‐Zhe; Yu, Guangjun; Zhang, Ting

doi:10.1097/md.0000000000004509

Cited by 166 publications

(132 citation statements)

References 75 publications

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“…In our analysis, we decided to show both scenarios to cover both more optimistic effects based on ‘low quality evidence’ (Cochrane) and more conservative effects based on a higher quality of evidence (YHEC). We acknowledge that the evidence around the preventive effects of probiotics is deemed preliminary by a number of scientists, in view of contradictory results: non-conclusive subgroup analyses by age group (YHEC) or efficacy not sufficiently ascertained according to Caffarelli et al [57], while two other meta-analyses including moderate quality [58] to high-quality [59] studies confirm the positive effect of probiotics on RTI incidence and symptoms. Despite practical or ethical challenges, it is expected that the quality of RCTs conducted in the nutrition area will substantially improve in the near future [60, 61].…”

Section: Limitationsmentioning

confidence: 99%

The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada

Lenoir-Wijnkoop

Gerlier²,

Roy

et al. 2016

PLoS ONE

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IntroductionThere is accumulating evidence supporting the use of probiotics, which are defined as “live micro-organisms which, when administered in adequate amounts, confer a health benefit on the host”, as a preventive measure against respiratory tract infections (RTI). Two recent meta-analyses showed probiotic consumption (daily intake of 107 to 1010 CFU in any form for up to 3 months) significantly reduced RTI duration, frequency, antibiotic use and work absenteeism.ObjectivesThe aim of this study was to assess the impact of probiotic use in terms of number of RTI episodes and days averted, and the number of antibiotic prescriptions and missed workdays averted, in the general population of Canada. In addition, the corresponding economic impact from both a healthcare payer and a productivity perspective was estimated.MethodsA microsimulation model was developed to reproduce the Canadian population (sample rate of 1/1000 = 35 540 individuals) employing age and gender. RTI incidence was taken from FluWatch consultation rates for influenza-like illness (2013–14) and StatCan all-cause consultations statistics. The model was calibrated on a 2.1% RTI annual incidence in the general population (5.2 million RTI days) and included known risk factors (smoking status, shared living conditions and vaccination status). RTI-related antibiotic prescriptions and work absenteeism were obtained from the literature.ResultsThe results indicate that probiotic use saved 573 000–2.3 million RTI-days, according to the YHEC–Cochrane scenarios respectively. These reductions were associated with an avoidance of 52 000–84 000 antibiotic courses and 330 000–500 000 sick-leave days. A projection of corresponding costs reductions amounted to Can$1.3–8.9 million from the healthcare payer perspective and Can$61.2–99.7 million when adding productivity losses.ConclusionThe analysis shows that the potential of probiotics to reduce RTI-related events may have a substantial clinical and economic impact in Canada.

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Section: Limitationsmentioning

confidence: 99%

The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada

Lenoir-Wijnkoop

Gerlier²,

Roy

et al. 2016

PLoS ONE

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“…Studies in mice show a relationship between disrupted microbiota and impaired immune control Biology of Blood and Marrow Transplantation journal homepage: www.bbmt.org of RVI in an antibiotic-treated mouse model, and the protective effect of Lactobacillus priming against lethal pneumonia virus [14][15][16][17][18]. Also, human studies show reduced respiratory disease severity with probiotic use in immunocompetent populations, and the association between low microbiome diversity and pulmonary complications including viral pneumonia in HCT recipients [19][20][21][22]. RVIs are frequently associated with lower respiratory tract disease (LRTD) and mortality in HCT recipients [23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Exposure Prior to Respiratory Viral Infection Is Associated with Progression to Lower Respiratory Tract Disease in Allogeneic Hematopoietic Cell Transplant Recipients

Ogimi

Krantz

Golob

et al. 2018

Biology of Blood and Marrow Transplantation

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Recent publications note an association between antibiotic exposure and respiratory viral infections (RVIs). Antibiotics affect microbiota and impair immune response against RVIs in mice, and low microbiome diversity is associated with pulmonary complications including viral lower respiratory tract disease (LRTD) in hematopoietic cell transplantation (HCT) recipients. In this study, we examined whether antibiotic exposure was associated with increased risk of disease progression in RVIs post-transplantation. We analyzed patients who underwent allogeneic HCT (June 2008 to February 2016) and had their first RVI due to parainfluenza virus (PIV), respiratory syncytial virus (RSV), or human metapneumovirus (MPV) during the initial 100 days post-transplantation. Antibiotic exposure in the 3 weeks before RVI onset was defined as (1) use of specific antibiotics versus none of these antibiotics and (2) number of antibiotic-days. Cox proportional hazards models were used to examine associations between antibiotic exposures and risk of viral disease progression to proven/probable/possible LRTD. Ninety HCT recipients (84 adults, 6 children) fulfilled study criteria; 33 progressed to LRTD. The number of antibiotic-days was associated with progression to LRTD after adjusting for neutropenia, steroid use, and either lymphopenia (hazard ratio, 1.41 [95% confidence interval, 1.04 to 1.92], P = .027) or monocytopenia (hazard ratio, 1.46 [95% confidence interval, 1.11 to 1.91], P = .006). Specific antibiotic classes was not associated with the outcome. Cumulative antibiotic exposure immediately before RVI onset is a risk factor for disease progression following PIV, RSV, and MPV infections post-transplantation. Larger cohort studies are needed to determine the impact of specific antibiotics or antibiotic classes on disease severity.

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“…Dietary supplements containing probiotics can modify the population of the gut microflora and may provide a practical means of enhancing gut and systemic immune function, which was shown to be beneficial by reducing the infection frequency in sensible groups, e.g., elderly in group homes or children [24,25]. However, studies in these subject groups might not be reflective of athletes who have different gut microbiota [26].…”

Section: Introductionmentioning

confidence: 99%

Probiotic Supplements Beneficially Affect Tryptophan–Kynurenine Metabolism and Reduce the Incidence of Upper Respiratory Tract Infections in Trained Athletes: A Randomized, Double-Blinded, Placebo-Controlled Trial

et al. 2016

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Background: Prolonged intense exercise has been associated with transient suppression of immune function and an increased risk of infections. In this context, the catabolism of amino acid tryptophan via kynurenine may play an important role. The present study examined the effect of a probiotic supplement on the incidence of upper respiratory tract infections (URTI) and the metabolism of aromatic amino acids after exhaustive aerobic exercise in trained athletes during three months of winter training. Methods: Thirty-three highly trained individuals were randomly assigned to probiotic (PRO, n = 17) or placebo (PLA, n = 16) groups using double blind procedures, receiving either 1 × 1010 colony forming units (CFU) of a multi-species probiotic (Bifidobacterium bifidum W23, Bifidobacterium lactis W51, Enterococcus faecium W54, Lactobacillus acidophilus W22, Lactobacillus brevis W63, and Lactococcus lactis W58) or placebo once per day for 12 weeks. The serum concentrations of tryptophan, phenylalanine and their primary catabolites kynurenine and tyrosine, as well as the concentration of the immune activation marker neopterin were determined at baseline and after 12 weeks, both at rest and immediately after exercise. Participants completed a daily diary to identify any infectious symptoms. Results: After 12 weeks of treatment, post-exercise tryptophan levels were lowered by 11% (a significant change) in the PLA group compared to the concentrations measured before the intervention (p = 0.02), but remained unchanged in the PRO group. The ratio of subjects taking the placebo who experienced one or more URTI symptoms was increased 2.2-fold compared to those on probiotics (PLA 0.79, PRO 0.35; p = 0.02). Conclusion: Data indicate reduced exercise-induced tryptophan degradation rates in the PRO group. Daily supplementation with probiotics limited exercise-induced drops in tryptophan levels and reduced the incidence of URTI, however, did not benefit athletic performance.

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Probiotics for prevention and treatment of respiratory tract infections in children

Abstract: Supplemental Digital Content is available in the text

Cited by 166 publications

References 75 publications

The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada

The Clinical and Economic Impact of Probiotics Consumption on Respiratory Tract Infections: Projections for Canada

Antibiotic Exposure Prior to Respiratory Viral Infection Is Associated with Progression to Lower Respiratory Tract Disease in Allogeneic Hematopoietic Cell Transplant Recipients

Probiotic Supplements Beneficially Affect Tryptophan–Kynurenine Metabolism and Reduce the Incidence of Upper Respiratory Tract Infections in Trained Athletes: A Randomized, Double-Blinded, Placebo-Controlled Trial

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