Network meta‐analysis of probiotics to prevent respiratory infections in children and adolescents

Abstract

Probiotics have emerged as a promising intervention for the prevention of respiratory tract infections (RTIs) in children. Assess the effect of probiotics on prevention of RTIs in children and adolescents. MEDLINE, EMBASE, LILACS, SCIELO, CINAHL, SCOPUS, and Web of Science. Key words: "respiratory tract infections" AND probiotics. Randomized controlled trials RCT assessing the effect of probiotics on RTIs in children and adolescents were included. Two reviewers, working independently, to identify studies that met the eligibility criteria. Main and secondary outcomes were RTIs and adverse effects, respectively. Twenty-one trials with 6.603 participants were included. Pairwise meta-analysis suggested that Lactobacillus casei rhamnosus (LCA) was the only effective probiotic to the rate of RTIs compared to placebo (RR0.38; Crl 0.19-0.45). Network analysis showed that the LCA exhibited 54.7% probability of being classified in first, while the probability of Lactobacillus fermentum CECT5716 (LFC) being last in the ranking was 15.3%. LCA showed no better effect compared to other probiotic strains by indirect analysis. This systematic review found a lack of evidence to support the effect of probiotic on the incidence rate of respiratory infections in children and adolescents. Pediatr Pulmonol. 2017;52:833-843. © 2017 Wiley Periodicals, Inc.

Postbiotics for Preventing and Treating Common Infectious Diseases in Children: A Systematic Review

“…Children younger than 5 years are especially vulnerable to infections; this predisposition is thought to be driven by a complex network of modulators, involving the immaturity of the immune response and organ function [1]. Since early 1980, the use of probiotics has been proposed to reduce the burden of common infectious disease among children [2][3][4][5] and infants [6]. However, a noteworthy part of the scientific community does not support probiotic interventions in younger children, due to rare case reports of probiotic-related infections such as bacteremia, necrotizing enterocolitis, pneumonia, and meningitis [7][8][9][10][11].…”

Randomized controlled trial on the impact of early-life intervention with bifidobacteria on the healthy infant fecal microbiota and metabolome

“…Although commercially available formulas are supplemented with bacteria considered as probiotics, little is known about their ability to modulate the infant gut microbial composition and function (5,6). The vast majority of published studies have focused on the use of probiotics in disease-related contexts, including necrotizing enterocolitis in preterm infants, gastrointestinal and respiratory infections, and allergic reactions (7)(8)(9)(10). Their use in healthy cohorts is common, but available data are limited in terms of repeated measurements over time and duration of probiotic administration (11)(12)(13).…”

The lung microbiome in neonates

“…59 Moreover, administration of Lactobacillus GG compared to placebo to children in day-care centers reduced the risk of developing upper respiratory tract infections. 60 In the network meta-analysis evaluating probiotics for the prevention of respiratory infections in children and adolescents by Amaral et al 61 , Lactobacillus casei rhamnosus uniquely demonstrated a superior effect in decreasing respiratory infection rates compared to placebo, while no beneficial outcome resulted from other probiotic strains. This study reinforces the general agreement that evidence is lacking for implementation of single or mixed probiotics usage therapeutically or prophylactically for respiratory infections.…”