Browse > Article
http://dx.doi.org/10.5223/pghn.2017.20.3.139

Probiotics in Children: What Is the Evidence?  

Hojsak, Iva (Children's Hospital Zagreb)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.20, no.3, 2017 , pp. 139-146 More about this Journal
Abstract
The number of papers discussing probiotics increases tremendously that limits the possibility for primary care physicians and clinicians to stay updated. Therefore, the aim of this paper will be to summarize available evidence of probiotic use in well-defined clinical indications of importance for pediatricians. Based on currently available evidence certain probiotic strains (Lactobacillus rhamnosus GG [LGG] and Saccharomyces boulardii) have proven effect in the treatment of acute gastroenteritis and prevention of antibiotic associated diarrhea. Furthermore, LGG was proven to be effective in prevention of nosocomial diarrhea and respiratory tract infection in day care centers. In conclusion, not all probiotic strains have same efficacy for all clinical indications, therefore, only strains with proven efficacy and safety should be recommended.
Keywords
Lactobacillus; Saccharomyces; Bifidobacterium; Diarrhea; Infection;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Dinleyici EC, Dalgic N, Guven S, Metin O, Yasa O, Kurugol Z, et al. Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatient setting. J Pediatr (Rio J) 2015;91:392-6.   DOI
2 Szajewska H, Canani RB, Guarino A, Hojsak I, Indrio F, Kolacek S, et al. Probiotics for the prevention of antibiotic-associated diarrhea in children. J Pediatr Gastroenterol Nutr 2016;62:495-506.   DOI
3 Missaghi B, Valenti AJ, Owens RC Jr. Clostridium difficile infection: a critical overview. Curr Infect Dis Rep 2008;10:165-73.   DOI
4 Slattery J, MacFabe DF, Frye RE. The significance of the enteric microbiome on the development of childhood disease: a review of prebiotic and probiotic therapies in disorders of childhood. Clin Med Insights Pediatr 2016;10:91-107.
5 Arvola T, Laiho K, Torkkeli S, Mykkanen H, Salminen S, Maunula L, et al. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics 1999;104:e64.   DOI
6 Issa I, Moucari R. Probiotics for antibiotic-associated diarrhea: do we have a verdict? World J Gastroenterol 2014;20:17788-95.   DOI
7 Monto AS. Epidemiology of viral respiratory infections. Am J Med 2002;112 Suppl 6A:4S-12S.
8 Dellepiane RM, Pavesi P, Patria MF, Laicini E, Di Landro G, Pietrogrande MC. Atopy in preschool Italian children with recurrent respiratory infections. Pediatr Med Chir 2009;31:161-4.
9 Silverstein M, Sales AE, Koepsell TD. Health care utilization and expenditures associated with child care attendance: a nationally representative sample. Pediatrics 2003;111:e371-5.   DOI
10 Haskins R. Acute illness in day care: how much does it cost? Bull N Y Acad Med 1989;65:319-43.
11 Hojsak I, Kolacek S. Probiotics and prebiotics in the prevention of respiratory tract infections. In: Orel R, ed. Intestinal microbiota, probiotics and prebiotics. Ljubljana: Institute for Probiotics and Functional Foods, Ltd., 2014:117-28.
12 Gutierrez-Castrellon P, Lopez-Velazquez G, Diaz-Garcia L, Jimenez-Gutierrez C, Mancilla-Ramirez J, Estevez-Jimenez J, et al. Diarrhea in preschool children and Lactobacillus reuteri: a randomized controlled trial. Pediatrics 2014;133:e904-9.   DOI
13 Hatakka K, Savilahti E, Ponka A, Meurman JH, Poussa T, Nase L, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ 2001;322:1327.   DOI
14 Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC. Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 2009;124: e172-9.   DOI
15 Hojsak I, Mocic Pavic A, Kos T, Dumancic J, Kolacek S. Bifidobacterium animalis subsp. lactis in prevention of common infections in healthy children attending day care centers-randomized, double blind, placebo-controlled study. Clin Nutr 2016;35:587-91.   DOI
16 Hojsak I, Snovak N, Abdovic S, Szajewska H, Misak Z, Kolacek S. 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. Clin Nutr 2010;29: 312-6.   DOI
17 Kumpu M, Kekkonen RA, Kautiainen H, Jarvenpaa S, Kristo A, Huovinen P, et al. Milk containing probiotic Lactobacillus rhamnosus GG and respiratory illness in children: a randomized, double-blind, placebo-controlled trial. Eur J Clin Nutr 2012;66:1020-3.   DOI
18 Lin JS, Chiu YH, Lin NT, Chu CH, Huang KC, Liao KW, et al. Different effects of probiotic species/strains on infections in preschool children: a double-blind, randomized, controlled study. Vaccine 2009;27:1073-9.   DOI
19 Merenstein D, Gonzalez J, Young AG, Roberts RF, Sanders ME, Petterson S. Study to investigate the potential of probiotics in children attending school. Eur J Clin Nutr 2011;65:447-53.   DOI
20 Merenstein D, Murphy M, Fokar A, Hernandez RK, Park H, Nsouli H, et al. 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. Eur J Clin Nutr 2010;64:669-77.   DOI
21 Wang Y, Li X, Ge T, Xiao Y, Liao Y, Cui Y, et al. Probiotics for prevention and treatment of respiratory tract infections in children: a systematic review and metaanalysis of randomized controlled trials. Medicine (Baltimore) 2016;95:e4509.   DOI
22 Merenstein DJ, Smith KH, Scriven M, Roberts RF, Sanders ME, Petterson S. The study to investigate the potential benefits of probiotics in yogurt, a patient-oriented, double-blind, cluster-randomised, placebo-controlled, clinical trial. Eur J Clin Nutr 2010;64:685-91.   DOI
23 Saavedra JM, Abi-Hanna A, Moore N, Yolken RH. Long-term consumption of infant formulas containing live probiotic bacteria: tolerance and safety. Am J Clin Nutr 2004;79:261-7.   DOI
24 Weizman Z, Asli G, Alsheikh A. Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 2005;115:5-9.   DOI
25 World Health Organization. Prevention of hospital-acquired infections. 2nd ed. Geneva: World Health Organization, 2002.
26 World Health Organization. Report on the burden of endemic health care-associated infection worldwide. Geneva: World Health Organization, 2011.
27 Hojsak I, Abdovic S, Szajewska H, Milosevic M, Krznaric Z, Kolacek S. Lactobacillus GG in the prevention of nosocomial gastrointestinal and respiratory tract infections. Pediatrics 2010;125:e1171-7.   DOI
28 Posfay-Barbe KM, Zerr DM, Pittet D. Infection control in paediatrics. Lancet Infect Dis 2008;8:19-31.   DOI
29 Hojsak I, Szajewska H, Canani RB, Guarino A, Indrio F, Kolacek S, et al. Probiotics for the prevention of nosocomial diarrhea in children. J Pediatr Gastroenterol Nutr 2017. doi: 10.1097/MPG.0000000000001637. [Epub ahead of print]
30 Ejemot-Nwadiaro RI, Ehiri JE, Arikpo D, Meremikwu MM, Critchley JA. Hand washing promotion for preventing diarrhoea. Cochrane Database Syst Rev 2015;(9):CD004265.
31 Wanke M, Szajewska H. Lack of an effect of Lactobacillus reuteri DSM 17938 in preventing nosocomial diarrhea in children: a randomized, double-blind, placebo-controlled trial. J Pediatr 2012;161:40-3.e1.   DOI
32 Urbanska M, Gieruszczak-Bialek D, Szymanski H, Szajewska H. Effectiveness of lactobacillus reuteri DSM 17938 for the prevention of nosocomial diarrhea in children: a randomized, double-blind, placebo-controlled trial. Pediatr Infect Dis J 2016;35:142-5.   DOI
33 Hojsak I, Tokic Pivac V, Mocic Pavic A, Pasini AM, Kolacek S. Bifidobacterium animalis subsp. lactis fails to prevent common infections in hospitalized children: a randomized, double-blind, placebo-controlled study. Am J Clin Nutr 2015;101:680-4.   DOI
34 Szajewska H, Guarino A, Hojsak I, Indrio F, Kolacek S, Shamir R, et al. Use of probiotics for management of acute gastroenteritis: a position paper by the ESPGHAN Working Group for Probiotics and Prebiotics. J Pediatr Gastroenterol Nutr 2014;58:531-9.   DOI
35 Food and Agricultural Organization of the United Nations, World Health Organization. Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria. Corboda: FAO, WHO, 2001.
36 Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 2014;11:506-14.   DOI
37 Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr 2014;59:132-52.   DOI
38 Enserink R, Mughini-Gras L, Duizer E, Kortbeek T, Van Pelt W. Risk factors for gastroenteritis in child day care. Epidemiol Infect 2015;143:2707-20.   DOI
39 Gordon M, Akobeng A. Racecadotril for acute diarrhoea in children: systematic review and meta-analyses. Arch Dis Child 2016;101:234-40.   DOI
40 Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev 2010;(11):CD003048.
41 Szajewska H, Urbanska M, Chmielewska A, Weizman Z, Shamir R. Meta-analysis: Lactobacillus reuteri strain DSM 17938 (and the original strain ATCC 55730) for treating acute gastroenteritis in children. Benef Microbes 2014;5:285-93.   DOI
42 Szajewska H, Skorka A, Ruszczynski M, Gieruszczak-Bialek D. Meta-analysis: Lactobacillus GG for treating acute gastroenteritis in children--updated analysis of randomised controlled trials. Aliment Pharmacol Ther 2013;38:467-76.   DOI
43 Dinleyici EC, Eren M, Ozen M, Yargic ZA, Vandenplas Y. Effectiveness and safety of Saccharomyces boulardii for acute infectious diarrhea. Expert Opin Biol Ther 2012;12:395-410.   DOI
44 Rosander A, Connolly E, Roos S. Removal of antibiotic resistance gene-carrying plasmids from Lactobacillus reuteri ATCC 55730 and characterization of the resulting daughter strain, L. reuteri DSM 17938. Appl Environ Microbiol 2008;74:6032-40.   DOI