Probiotics in Pediatrics. A Review and Practical Guide

Abstract

The potential benefit of the administration of probiotics in children has been studied in many settings globally. Probiotics products contain viable micro-organisms that confer a health benefit on the host. Beneficial effects of selected probiotic strains for the management or prevention of selected pediatric conditions have been demonstrated. The purpose of this paper is to provide an overview of current available evidence on the efficacy of specific probiotics in selected conditions to guide pediatricians in decision-making on the therapeutic or prophylactic use of probiotic strains in children. Evidence to support the use of certain probiotics in selected pediatric conditions is often available. In addition, the administration of probiotics is associated with a low risk of adverse events and is generally well tolerated. The best documented efficacy of certain probiotics is for treatment of infectious gastroenteritis, and prevention of antibiotic-associated, Clostridioides difficile-associated and nosocomial diarrhea. Unfortunately, due to study heterogeneity and in some cases high risk of bias in published studies, a broad consensus is lacking for specific probiotic strains, doses and treatment regimens for some pediatric indications. The current available evidence thus limits the systematic administration of probiotics. The most recent meta-analyses and reviews highlight the need for more well-designed, properly powered, strain-specific and dedicated-dose response studies.

Which Probiotic Is the Most Effective for Treating Acute Diarrhea in Children? A Bayesian Network Meta-Analysis of Randomized Controlled Trials

“…Compared with no treatment, low or very low evidence represented that the following probiotics could shorten the duration of diarrhea: S. boulardii (MD = −0.95 day; 95%CI, −1.33, −0.58), LGG (MD = −1.57 day; 95%CI, −2. 13 1). B. lactis had the highest probability of reducing the duration of diarrhea when compared with no treatment (Supplementary Material Table S27).…”

“…However, it cannot halt the progression of diarrhea, nor address microflora imbalance, pathogen clearance, and environmental enteric dysfunction [11,12], all of them may be addressed by probiotics. Probiotics were recommended as adjuncts to effectively alleviate and treat diarrhea by clinical practice guidelines and numerous studies [7,[13][14][15]. Traditional pairwise meta-analysis only focused on one probiotic and failed to find the most effective probiotic [6,[16][17][18].…”

Unity of bowel-lung axis and the role of beneficial microbiota in anti-infectious protection

“…Современные представления о возможностях лечебно-профилактического использования пробиотиков (и пробиотических продуктов) у детей с респираторными инфекциями также неоднозначны [18][19][20][21][22][23][24][25].…”

Probiotic Supplementation for Promotion of Growth in Children: A Systematic Review and Meta-Analysis

“…Observational and experimental studies from community settings have shown that gut microbiota immaturity or dysbiosis is associated with risk of development of acute malnutrition and linear growth failure in children [ 2 , 3 , 4 , 5 ]. Probiotics are one of the commonly used products to promote healthy gut microbiomes, encompassing a USD 54 billion industry around the globe [ 6 , 7 ]. Probiotics are defined as live microorganisms that, when administered in adequate amounts, confer a health benefit to the host [ 8 ].…”