The effect of probiotics on prevention of upper respiratory tract infections in the paediatric community â a systematic review
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Prevention of acute upper respiratory tract infections (URTIs) is becoming an increasingly important concept in public health application due to the increase in antibiotic resistance. Probiotics have been shown to have some effect on prevention in various reviews. In this study we aimed to re-asses the effect of probiotics as there has been a substantial increase in literature regarding the effects and safety of probiotics in the paediatric population. Two major databases were systematically searched to identify clinical trials eligible for inclusion. Study selection, data extraction and quality assessment were carried out by two reviewers. This review comprises 33 randomised controlled trials (RCTs) applied to a paediatric population with high-quality methodology. The primary outcome for this review was the incidence of respiratory tract infections. Secondary outcomes were severity of symptoms, missed days of school, incidence of antibiotic use and safety of prebiotic use. This review showed that probiotics have an impact on decreasing the incidence of URTIs and the severity of symptoms. The use of probiotics is extremely safe and as studies increase in evaluation of the effect of probiotics more and more show a significant beneficiary effect. Although still a long way from becoming a unanimous treatment modality, the small positive changes that probiotics have on URTIs is important to consider and the use of probiotics should be encouraged more.
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Bagger, K., Nielsen, A.B., Siersma, V. and Bjerrum, L., 2015. Inappropriate antibiotic prescribing and demand for antibiotics in patients with upper respiratory tract infections is hardly different in female versus male patients as seen in primary care. European Journal of General Practice 21: 118-123. https://doi.org/10.3109/13814788.2014.100136
-
Bell, B.G., Schellevis, F., Stobberingh, E., Goossens, H. and Pringle, M., 2014. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BioMed Central Infectious Diseases 14: 13. https://doi.org/10.1186/1471-2334-14-13
-
Bruzzese, E., Fedele, M.C., Bruzzese, D., Viscovo, S., Giannattasio, A., Mandato, C., Siani, P. and Guarino, A., 2016. Randomised clinical trial: a Lactobacillus GG and micronutrient-containing mixture is effective in reducing nosocomial infections in children, vs. placebo. Alimentary Pharmacology and Therapeutics 44: 568-575. https://doi.org/10.1111/apt.13740
-
Cáceres, P., Montes, S., Vega, N., Cruchet, S., Brunser, O. and Gotteland, M., 2010. Effects of Lactobacillus rhamnosus HN001 on acute respiratory infections and intestinal secretory IgA in children. Journal of Pediatric Infectious Diseases 5: 353-362. https://doi.org/10.3233/JPI-2010-0267
-
Cazzola, M., Pham-Thi, N., Kerihuel, J.C., Durand, H. and Bohbot, S., 2010. Efficacy of a synbiotic supplementation in the prevention of common winter diseases in children: a randomized, double-blind, placebo-controlled pilot study. Therapeutic Advances in Respiratory Disease 4: 271-278. https://doi.org/10.1177/1753465810379010
-
Cobo Sanz, J.M., Mateos, J.A. and Munoz Conejo, A., 2006. Effect of Lactobacillus casei on the incidence of infectious conditions in children. Nutricion Hospitalaria 21: 547-551.
'Effect of Lactobacillus casei on the incidence of infectious conditions in children ' () 21 Nutricion Hospitalaria : 547 -551 .
-
Corsello, G., Carta, M., Marinello, R., Picca, M., De Marco, G., Micillo, M., Ferrara, D., Vigneri, P., Cecere, G., Ferri, P., Roggero, P., Bedogni, G., Mosca, F., Paparo, L., Nocerino, R. and Berni Canani, R., 2017. Preventive effect of cowâs milk fermented with Lactobacillus paracasei CBA L74 on common infectious diseases in children: a multicenter randomized controlled trial. Nutrients 9: 669. https://doi.org/10.3390/nu9070669
-
De Sa Del Fiol, F., Barberato-Filho, S., Lopes, L.C. and De Cassia Bergamaschi, C., 2015. Vitamin D and respiratory infections. Journal of Infection in Developing Countries 9: 355-361. https://doi.org/10.3855/jidc.5711
-
Di Pierro, F., Colombo, M., Giuliani, M.G., Danza, M.L., Basile, I., Bollani, T., Conti, A.M., Zanvit, A. and Rottoli, A.S., 2016. Effect of administration of Streptococcus salivarius K12 on the occurrence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media in 3 years old children. European Review for Medical and Pharmacological Sciences 20: 4601-4606.
'Effect of administration of Streptococcus salivarius K12 on the occurrence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media in 3 years old children ' () 20 European Review for Medical and Pharmacological Sciences : 4601 -4606 .
-
DÃez-Domingo, J., Pérez-Yarza, E.G. Melero, J.A., Sánchez-Luna, M., Aguilar, M.D., Blasco, A.J., Alfaro, N. and Lázaro, P., 2014. Social, economic, and health impact of the respiratory syncytial virus: a systematic search. BioMed Central Infectious Diseases 14: 544. https://doi.org/10.1186/s12879-014-0544-x
-
Esposito, S., Rigante, D. and Principi, N., 2014. Do childrenâs upper respiratory tract infections benefit from probiotics? BioMed Central Infectious Diseases 14: 194. https://doi.org/10.1186/1471-2334-14-194
-
Feleszko, W., RuszczyÅski, M. and Zalewski, B.M., 2014. Non-specific immune stimulation in respiratory tract infections. Separating the wheat from the chaff. Paediatric Respiratory Reviews 15: 200-206. https://doi.org/10.1016/j.prrv.2013.10.006
-
Garaiova, I., Muchová, J., Nagyová, Z., Wang, D., Li, J.V., Országhová, Z., Michael, D.R., Plummer, S.F. and ÄuraÄková, Z., 2015. Probiotics and vitamin C for the prevention of respiratory tract infections in children attending preschool: a randomised controlled pilot study. European Journal of Clinical Nutrition 69: 373-379. https://doi.org/10.1038/ejcn.2014.174
-
Gerasimov, S.V., Ivantsiv, V.A., Bobryk, L.M., Tsitsura, O.O., Dedyshin, L.P., Guta, N.V. and Yandyo, B.V., 2016. Role of short-term use of L. acidophilus DDS-1 and B. lactis UABLA-12 in acute respiratory infections in children: a randomized controlled trial. European Journal of Clinical Nutrition 70: 463-469. https://doi.org/10.1038/ejcn.2015.171
-
Hao, Q., Lu, Z., Dong, B.R., Huang, C.Q. and Wu, T., 2011. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Systematic Reviews 7: CD006895. https://doi.org/10.1002/14651858.CD006895.pub2
-
Hatakka, K., Savilahti, E., Pönkä, A., Meurman, J.H., Poussa, T., Näse, L., Saxelin, M. and Korpela, R., 2001. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ 322: 1327. https://doi.org/10.1136/bmj.322.7298.1327
-
Hill, C., Guarner, F., Reid, G., Gibson, G.R., Merenstein, D.J., Pot, B., Morelli, L., Canani, R.B., Flint, H.J., Salminen, S., Calder, P.C. and Sanders, M.E., 2014. Expert consensus document. The international Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology and Hepatology 11: 506-514. https://doi.org/10.1038/nrgastro.2014.66
-
Hill, C., Guarner, F., Reid, G., Gibson, G.R., Merenstein, D.J., Pot, B., Morelli, L., Canani, R.B., Flint, H.J., Salminen, S., Calder, P.C. and Sanders, M.E., 2014. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nature Reviews Gastroenterology and Hepatology 11: 506-514. https://doi.org/10.1038/nrgastro.2014.66
-
Hojsak, I., 2017. Probiotics in children: what is the evidence? Pediatric Gastroenterology, Hepatology and Nutrition 20: 139-146. https://doi.org/10.5223/pghn.2017.20.3.139
-
Hojsak, I., AbdoviÄ, S., Szajewska, H., MiloseviÄ, M., KrznariÄ, Z. and Kolacek, S., 2010a. Lactobacillus GG in the prevention of nosocomial gastrointestinal and respiratory tract infections. Pediatrics 125: e1171-1177. https://doi.org/10.1542/peds.2009-2568
-
Hojsak, I., MoÄiÄ PaviÄ, A., Kos, T., DumanÄiÄ, J. and KolaÄek, S., 2016. Bifidobacterium animalis subsp. lactis in prevention of common infections in healthy children attending day care centers â randomized, double blind, placebo-controlled study. Clinical Nutrition 35: 587-591. https://doi.org/10.1016/j.clnu.2015.05.004
-
Hojsak, I., Snovak, N., AbdoviÄ, S., Szajewska, H., Misak, Z. and Kolacek, S., 2010b. Lactobacillus GG in the prevention of gastrointestinal and respiratory tract infections in children who attend day care centers: a randomized, double-blind, placebo-controlled trial. Clinical Nutrition 29: 312-316. https://doi.org/10.1016/j.clnu.2009.09.008
-
Hojsak, I., TokiÄ Pivac, V., MoÄiÄ PaviÄ, A., Pasini, A.M. and KolaÄek, S., 2015. Bifidobacterium animalis subsp. lactis fails to prevent common infections in hospitalized children: a randomized, double-blind, placebo-controlled study. American Journal of Clinical Nutrition 101: 680-684. https://doi.org/10.3945/ajcn.114.102004
-
Holstiege, J., Schink, T., Molokhia, M., Mazzaglia, G., Innocenti, F., Oteri, A., Bezemer, I., Poluzzi, E., Puccini, A., Ulrichsen, S. P., Sturkenboom, M.C., Trifirò, G. and Garbe, E., 2014. Systemic antibiotic prescribing to paediatric outpatients in 5 European countries: a population-based cohort study. BMC Pediatrics 14: 174. https://doi.org/10.1186/1471-2431-14-174
-
Johnson, C.L. and Versalovic, J., 2012. The human microbiome and its potential importance to pediatrics. Pediatrics 129: 950-960. https://doi.org/10.1542/peds.2011-2736
-
King, S., Glanville, J., Sanders, M.E., Fitzgerald, A. and Varley, D., 2014. Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis. British Journal of Nutrition 112: 41-54. https://doi.org/10.1017/S0007114514000075
-
Kukkonen, K., Savilahti, E., Haahtela, T., Juntunen-Backman, K., Korpela, R., Poussa, T., Tuure, T. and Kuitunen, M., 2008. Long-term safety and impact on infection rates of postnatal probiotic and prebiotic (synbiotic) treatment: randomized, double-blind, placebo-controlled trial. Pediatrics 122: 8-12. https://doi.org/10.1542/peds.2007-1192
-
Kumpu, M., Kekkonen, R.A., Kautiainen, H., Järvenpää, S., Kristo, A., Huovinen, P., Pitkäranta, A., Korpela, R. and Hatakka, K., 2012. Milk containing probiotic Lactobacillus rhamnosus GG and respiratory illness in children: a randomized, double-blind, placebo-controlled trial. European Journal of Clinical Nutrition 66: 1020-1023. https://doi.org/10.1038/ejcn.2012.62
-
Kumpu, M., Lehtoranta, L., Roivainen, M., Rönkkö, E., Ziegler, T., Söderlund-Venermo, M., Kautiainen, H., Järvenpää, S., Kekkonen, R., Hatakka, K., Korpela, R. and Pitkäranta, A., 2013. The use of the probiotic Lactobacillus rhamnosus GG and viral findings in the nasopharynx of children attending day care. Journal of Medical Virology 85: 1632-1638. https://doi.org/10.1002/jmv.23623
-
Laurent, C., Dugue, A.E., Brouard, J., Nimal, D., Parienti, J.J. and Vabret, A., 2012. Viral epidemiology and severity of respiratory infections in infants in 2009 a prospective study. The Pediatric Infectious Disease Journal 31: 827-831. https://doi.org/10.1097/inf.0b013e3182566005
-
Laursen, R.P. and Hojsak, I., 2018. Probiotics for respiratory tract infections in children attending day care centers â a systematic review. European Journal of Pediatrics 177: 979-994. https://doi.org/10.1007/s00431-018-3167-1
-
Laursen, R.P., Larnkjær, A., Ritz, C., Hauger, H., Michaelsen, K.F. and Mølgaard, C., 2017. Probiotics and child care absence due to infections: a randomized controlled trial. Pediatrics 140: e20170735. https://doi.org/10.1542/peds.2017-0735
-
Leyer, G.J., Li, S., Mubasher, M.E., Reifer, C. and Ouwehand, A.C., 2009. Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 124: e172-179. https://doi.org/10.1542/peds.2008-2666
-
Lin, J.S., Chiu, Y.H., Lin, N.T., Chu, C.H., Huang, K.C., Liao, K.W. and Peng, K.C., 2009. Different effects of probiotic species/strains on infections in preschool children: a double-blind, randomized, controlled study. Vaccine 27: 1073-1079. https://doi.org/10.1016/j.vaccine.2008.11.114
-
Liu, S., Hu, P., Du, X., Zhou, T. and Pei, X., 2013. Lactobacillus rhamnosus GG supplementation for preventing respiratory infections in children: a meta-analysis of randomized, placebo-controlled trials. Indian Pediatrics 50: 377-381. https://doi.org/10.1007/s13312-013-0123-z
-
Luoto, R., Ruuskanen, O., Waris, M., Kalliomäki, M., Salminen, S. and Isolauri, E., 2014. Prebiotic and probiotic supplementation prevents rhinovirus infections in preterm infants: a randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology 133: 405-413. https://doi.org/10.1016/j.jaci.2013.08.020
-
Marseglia, G.L., Tosca, M., Cirillo, I., Licari, A., Leone, M., Marseglia, A., Castellazzi, A.M. and Ciprandi, G., 2007. Efficacy of Bacillus clausii spores in the prevention of recurrent respiratory infections in children: a pilot study. Therapeutics and Clinical Risk Management 3: 13-17. https://doi.org/10.2147/tcrm.2007.3.1.13
-
Merenstein, D., Gonzalez, J., Young, A.G., Roberts, R.F., Sanders, M.E. and Petterson, S., 2011. Study to investigate the potential of probiotics in children attending school. European Journal of Clinical Nutrition 65: 447-453. https://doi.org/10.1038/ejcn.2010.290
-
Merenstein, D., Murphy, M., Fokar, A., Hernandez, R.K., Park, H., Nsouli, H., Sanders, M.E., Davis, B.A., Niborski, V., Tondu, F. and Shara, N.M., 2010a. Use of a fermented dairy probiotic drink containing Lactobacillus casei (DN-114 001) to decrease the rate of illness in kids: the DRINK study. A patient-oriented, double-blind, cluster-randomized, placebo-controlled, clinical trial. European Journal of Clinical Nutrition 64: 669-677. https://doi.org/10.1038/ejcn.2010.65
-
Merenstein, D.J., Smith, K.H., Scriven, M., Roberts, R.F., Sanders, M.E. and Petterson, S., 2010b. The study to investigate the potential benefits of probiotics in yogurt, a patient-oriented, double-blind, cluster-randomised, placebo-controlled, clinical trial. European Journal of Clinical Nutrition 64: 685-691. https://doi.org/10.1038/ejcn.2010.30
-
Meuer, S., 2010. Probiotics and respiratory tract diseases. Annals of Nutrition and Metabolism 57, Suppl.: 24-26. https://doi.org/10.1159/000317350
-
Nocerino, R., Paparo, L., Terrin, G., Pezzella, V., Amoroso, A., Cosenza, L., Cecere, G., De Marco, G., Micillo, M., Albano, F., Nugnes, R., Ferri, P., Ciccarelli, G., Giaccio, G., Spadaro, R., Maddalena, Y., Berni Canani, F. and Berni Canani, R., 2017. Cowâs milk and rice fermented with Lactobacillus paracasei CBA L74 prevent infectious diseases in children: a randomized controlled trial. Clinical Nutrition 36: 118-125. https://doi.org/10.1016/j.clnu.2015.12.004
-
Ozen, M., Kocabas Sandal, G. and Dinleyici, E.C., 2015. Probiotics for the prevention of pediatric upper respiratory tract infections: a systematic review. Expert Opinion on Biological Therapy 15: 9-20. https://doi.org/10.101610.1517/14712598.2015.980233
-
Prodeus, A., Niborski, V., Schrezenmeir, J., Gorelov, A., Shcherbina, A. and Rumyantsev, A., 2016. Fermented milk consumption and common infections in children attending day-care centers: a randomized trial. Journal of Pediatric Gastroenterology and Nutrition 63: 534-543. https://doi.org/10.1097/MPG.0000000000001248
-
Rautava, S., Salminen, S. and Isolauri, E., 2009. Specific probiotics in reducing the risk of acute infections in infancy â a randomised, double-blind, placebo-controlled study. British Journal of Nutrition 101: 1722-1726. https://doi.org/10.1017/S0007114508116282
-
Rerksuppaphol, S. and Rerksuppaphol, L., 2012. Randomized controlled trial of probiotics to reduce common cold in schoolchildren. Pediatrics International 54: 682-687. https://doi.org/10.1111/j.1442-200X.2012.03647.x
-
Rousounidis, A., Papaevangelou, V., Hadjipanayis, A., Panagakou, S., Theodoridou, M., Syrogiannopoulos, G. and Hadjichristodoulou, C., 2011. Descriptive study on parentsâ knowledge, attitudes and practices on antibiotic use and misuse in children with upper respiratory tract infections in Cyprus. International Journal of Environmental Research and Public Health 8: 3246-3262. https://doi.org/10.3390/ijerph8083246
-
Sæterdal, I., Underland, V. and Nilsen, E.S., 2012. The effect of probiotics for preventing acute upper respiratory tract infections. Global Advances in Health and Medicine 1: 124-125. https://doi.org/10.7453/gahmj.2012.1.2.014
-
Sazawal, S., Dhingra, U., Hiremath, G., Sarkar, A., Dhingra, P., Dutta, A., Verma, P., Menon, V.P. and Black, R.E., 2010. Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial. PLoS ONE 5: e12164. https://doi.org/10.1371/journal.pone.0012164
-
Schroeck, J.L., Ruh, C.A., Sellick Jr, J.A., Ott, M.C., Mattappallil, A. and Mergenhagen, K.A., 2015. Factors associated with antibiotic misuse in outpatient treatment for upper respiratory tract infections. Antimicrobial Agents and Chemotherapy 59: 3848-3852. https://doi.org/10.1128/AAC.00652-15
-
Smerud, H.K., Kleiveland, C.R., Mosland, A.R., Grave, G. and Birkeland, S.-E., 2009. Effect of a probiotic milk product on gastrointestinal and respiratory infections in children attending day-care. Microbial Ecology in Health and Disease 20: 80-85. https://doi.org/10.1080/08910600801924928
-
Swanljung, E., Tapiovaara, L., Lehtoranta, L., Mäkivuokko, H., Roivainen, M., Korpela, R. and Pitkäranta, A., 2015. Lactobacillus rhamnosus GG in adenoid tissue: double-blind, placebo-controlled, randomized clinical trial. Acta Oto-Laryngologica 135: 824-830. https://doi.org/10.3109/00016489.2015.1027412
-
Taipale, T., Pienihäkkinen, K., Isolauri, E., Larsen, C., Brockmann, E., Alanen, P., Jokela, J. and Söderling, E., 2011. Bifidobacterium animalis subsp. lactis BB-12 in reducing the risk of infections in infancy. British Journal of Nutrition 105: 409-416. https://doi.org/10.1017/S0007114510003685
-
Taipale, T.J., Pienihäkkinen, K., Isolauri, E., Jokela, J.T. and Söderling, E.M., 2016. Bifidobacterium animalis subsp. lactis BB-12 in reducing the risk of infections in early childhood. Pediatric Research 79: 65-69. https://doi.org/10.1038/pr.2015.174
-
Vandevelde, N.M., Tulkens, P.M. and Van Bambeke, F., 2016. Modulating antibiotic activity towards respiratory bacterial pathogens by co-medications: a multi-target approach. Drug Discovery Today 21: 1114-1129. https://doi.org/10.1016/j.drudis.2016.04.001
-
Vouloumanou, E.K., Makris, G.C., Karageorgopoulos, D.E. and Falagas, M.E., 2009. Probiotics for the prevention of respiratory tract infections: a systematic review. International Journal of Antimicrobial Agents 34: 197. https://doi.org/10.1016/j.ijantimicag.2008.11.005
-
Wang, J.L., Chang, C.H., Lin, J.W., Wu, L.C., Chuang, L.M. and Lai, M.S., 2014. Infection, antibiotic therapy and risk of colorectal cancer: a nationwide nested case-control study in patients with type 2 diabetes mellitus. International Journal of Cancer 135: 956-967 https://doi.org/10.1002/ijc.28738
-
Wang, Y., Li, X., Ge, T., Xiao, Y., Liao, Y., Cui, Y., Zhang, Y., Ho, W., Yu, G. and Zhang, T., 2016. Probiotics for prevention and treatment of respiratory tract infections in children: a systematic review and meta-analysis of randomized controlled trials. Medicine 95: e4509. https://doi.org/10.1097/MD.0000000000004509
-
Weizman, Z., 2012. Prevention of daycare infections. Functional Food Reviews 4: 158-163. https://doi.org/10.2310/6180.2009.00029
-
Wolvers, D., Antoine, J.M., Myllyluoma, E., Schrezenmeir, J., Szajewska, H. and Rijkers, G.T., 2010. Guidance for substantiating the evidence for beneficial effects of probiotics: prevention and management of infections by probiotics. Journal of Nutrition 140: 698S-712S. https://doi.org/10.3945/jn.109.113753
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The effect of probiotics on prevention of upper respiratory tract infections in the paediatric community â a systematic review
In: Beneficial MicrobesSearch for other papers by Ä°.E. Emre in
Current site
Google Scholar
PubMed
Search for other papers by Y. EroÄlu in
Current site
Google Scholar
PubMed
Search for other papers by A. Kara in
Current site
Google Scholar
PubMed
Search for other papers by E.C. Dinleyici in
Current site
Google Scholar
PubMed
Search for other papers by M. Ãzen in
Current site
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PubMed
Prevention of acute upper respiratory tract infections (URTIs) is becoming an increasingly important concept in public health application due to the increase in antibiotic resistance. Probiotics have been shown to have some effect on prevention in various reviews. In this study we aimed to re-asses the effect of probiotics as there has been a substantial increase in literature regarding the effects and safety of probiotics in the paediatric population. Two major databases were systematically searched to identify clinical trials eligible for inclusion. Study selection, data extraction and quality assessment were carried out by two reviewers. This review comprises 33 randomised controlled trials (RCTs) applied to a paediatric population with high-quality methodology. The primary outcome for this review was the incidence of respiratory tract infections. Secondary outcomes were severity of symptoms, missed days of school, incidence of antibiotic use and safety of prebiotic use. This review showed that probiotics have an impact on decreasing the incidence of URTIs and the severity of symptoms. The use of probiotics is extremely safe and as studies increase in evaluation of the effect of probiotics more and more show a significant beneficiary effect. Although still a long way from becoming a unanimous treatment modality, the small positive changes that probiotics have on URTIs is important to consider and the use of probiotics should be encouraged more.
| All Time | Past 365 days | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1109 | 412 | 22 |
| Full Text Views | 31 | 6 | 0 |
| PDF Views & Downloads | 56 | 23 | 0 |
