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

Abstract

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.

Evaluation of the efficacy of Lactobacillus plantarum HEAL9 and Lactobacillus paracasei 8700:2 on aspects of common cold infections in children attending day care: a randomised, double-blind, placebo-controlled clinical study

“…Although there is in general no doubt for the probiotic efficacy, the strain specificity is underlined as well as the importance of having strain-specific evidence for efficacy and safety, generated and confirmed in welldesigned randomised clinical trials. Moreover, based on health-economic analyses, it was reported that probiotics can substantially reduce the socioeconomic burden associated with common upper respiratory tract infections experienced by both adults and children [5,6]. The combination of Lactobacillus plantarum HEAL9 and Lactobacillus paracasei 8700:2 has previously been shown to reduce the incidence, duration and severity of common colds in adults [7,8].…”

Clinical Ecology—Transforming 21st-Century Medicine with Planetary Health in Mind

“…In addition to dietary prescriptions based on microbiome bioinformatics [97], other microbe-derived therapies are on the horizon. Already, probiotics, prebiotics, and postbiotics (e.g., heat-inactivated microbes or microbial parts) are being utilized for personal and public health benefit [98][99][100][101][102][103]. Fecal microbiota transplant, already of known value in Clostridium difficile infection [104], may provide benefit in various extra-intestinal NCDs [105,106].…”

Interspecies comparison of probiotics isolated from different animals

“…Specific probiotics have been suggested to be effective in alleviating the duration and severity of acute rotavirus gastroenteritis [ 14 , 15 ]. In addition, probiotics are able to reduce the risk of respiratory tract infections [ 7 , 16 ] which in most cases are of viral origin. Probiotics are likely to have an impact through gut mucosa by balancing the local microbiota [ 17 ], by inhibiting the growth of pathogenic microorganisms [ 18 ], and by enhancing local and systemic immune responses [ 19 ].…”