Probiotics Prevent Respiratory Infection in Children

January 18, 2015
Jeannette Y. Wick, RPh, MBA, FASCP

Because upper respiratory tract infections cost $40 billion annually in the United States, even a small reduction in incidence would have significant economic consequences.

Because upper respiratory tract infections (URTIs) cost $40 billion annually in the United States, even a small reduction in incidence would have significant economic consequences.

However, treating children’s acute viral URTIs inappropriately with antibiotics increases the risk and burden of antibiotic-resistant bacteria strains. As an alternate strategy, prophylactic probiotic use may help decrease URTI incidence and severity, but past studies on the subject have produced contradictory results due to differences in probiotic strains used and dosages and durations of probiotic therapy.

The January 2015 edition of Expert Opinion on Biological Therapy included the first-ever systematic review of probiotics’ effects on the incidence of URTIs in children. In it, the authors reviewed 14 randomized controlled trials, of which 12 were scored as extremely high quality, while the remaining 2 were scored as very good.

All 14 trials used the 2 most common bacteria probiotic strains—Lactobacillus and Bifidobacterium—but dosing, duration, and route of administration varied widely. Typically, the children’s parents administered the probiotics, and those parents were also responsible for noting URTI incidence and severity.

Half of the trials demonstrated statistically significant decreases of 5% to 10% in URTI incidence in the probiotic groups. Additionally, 7 of the 11 studies that tracked URTI symptom severity found significant decreases in such severity among the probiotic groups.

In light of those findings, the review authors concluded that probiotics are moderately effective prophylactic agents against URTIs and are worthy of recommendation to interested patients, especially given that the safety profile of probiotics is mundane.

The researchers also identified a number of areas for future research on probiotics, including further studies that:

· Focus on certain populations, evaluate stool samples, and examine non-oral delivery of probiotics.

· Examine probiotics use in patients with and without pneumococcal and influenza vaccination.

· Expand upon research in school age and teenage children and HIV-positive patients to target populations in which reducing URTI would have enormous economic consequences.

· Follow patients for period of time longer than 3 months in order to document long- and short-term effects.