In the Journals

Probiotics help reduce pediatric antibiotic use

Taking probiotics to reduce the risk for common acute infections might also be linked with a reduction in antibiotic use among children and infants, according to a meta-analysis published in the European Journal of Public Health.

Dan Merenstein, MD, of the department of family medicine at Georgetown University School of Medicine, and colleagues said that reducing antibiotic use could help combat the spread of antibiotic-resistant infections.

“We already have evidence that consuming probiotics reduces the incidence, duration, and severity of certain types of common acute respiratory and gastrointestinal infections,” Merenstein said in a press release. “The question is whether that reduction is solidly linked to declining use of antibiotics, and we see that there is an association.”

Investigators searched the literature for randomized controlled trials that assessed the impact of probiotic use on antibiotic utilization for common, acute infections compared with placebo.

Merenstein and colleagues identified 17 studies that used 13 probiotics formulations, including single or combination Lactobacillus and Bifidobacterium delivered through food or supplements. Patients across all studies either took probiotics (n = 2,026) or placebo (n = 1,927).

During their meta-analysis, researchers found that patients who took probiotics had a lower risk for being prescribed antibiotics compared with patients who took placebo (pooled RR = 0.71; 95% CI, 0.54–0.94). When they limited their analysis to studies with a low risk for bias, investigators found that the risk was even lower (pooled RR = 0.46; 95% CI, 0.23–0.97).

Merenstein said there are several potential mechanisms through which probiotics might fight infections, including production of pathogen inhibitors and immune regulation.

“We don't know all the mechanisms probiotic strains may leverage,” he said in the press release. “But since most of the human immune system is found in the gastrointestinal tract, ingesting healthy bacteria may competitively exclude bacterial pathogens linked to gut infections and may prime the immune system to fight others.”

Investigators called for more research to confirm their findings and explore the effect of probiotics in other population groups.

“More studies are needed in all ages, and particularly in the elderly, to see if sustained probiotic use is connected to an overall reduction in antibiotic prescriptions,” lead author Sarah King, PhD, from Cambridge in the United Kingdom, said in the press release. “If so, this could potentially have a huge impact on the use of probiotics in general medicine and consumers in general.” – by Alex Young

Disclosures: Merenstein reports financial ties to Bayer, Pharmative and the International Scientific Association for Probiotics and Prebiotics. King reports financial ties to the International Scientific Association for Probiotics and Prebiotics. Please see the full study for all other authors’ relevant financial disclosures.

Taking probiotics to reduce the risk for common acute infections might also be linked with a reduction in antibiotic use among children and infants, according to a meta-analysis published in the European Journal of Public Health.

Dan Merenstein, MD, of the department of family medicine at Georgetown University School of Medicine, and colleagues said that reducing antibiotic use could help combat the spread of antibiotic-resistant infections.

“We already have evidence that consuming probiotics reduces the incidence, duration, and severity of certain types of common acute respiratory and gastrointestinal infections,” Merenstein said in a press release. “The question is whether that reduction is solidly linked to declining use of antibiotics, and we see that there is an association.”

Investigators searched the literature for randomized controlled trials that assessed the impact of probiotic use on antibiotic utilization for common, acute infections compared with placebo.

Merenstein and colleagues identified 17 studies that used 13 probiotics formulations, including single or combination Lactobacillus and Bifidobacterium delivered through food or supplements. Patients across all studies either took probiotics (n = 2,026) or placebo (n = 1,927).

During their meta-analysis, researchers found that patients who took probiotics had a lower risk for being prescribed antibiotics compared with patients who took placebo (pooled RR = 0.71; 95% CI, 0.54–0.94). When they limited their analysis to studies with a low risk for bias, investigators found that the risk was even lower (pooled RR = 0.46; 95% CI, 0.23–0.97).

Merenstein said there are several potential mechanisms through which probiotics might fight infections, including production of pathogen inhibitors and immune regulation.

“We don't know all the mechanisms probiotic strains may leverage,” he said in the press release. “But since most of the human immune system is found in the gastrointestinal tract, ingesting healthy bacteria may competitively exclude bacterial pathogens linked to gut infections and may prime the immune system to fight others.”

Investigators called for more research to confirm their findings and explore the effect of probiotics in other population groups.

“More studies are needed in all ages, and particularly in the elderly, to see if sustained probiotic use is connected to an overall reduction in antibiotic prescriptions,” lead author Sarah King, PhD, from Cambridge in the United Kingdom, said in the press release. “If so, this could potentially have a huge impact on the use of probiotics in general medicine and consumers in general.” – by Alex Young

Disclosures: Merenstein reports financial ties to Bayer, Pharmative and the International Scientific Association for Probiotics and Prebiotics. King reports financial ties to the International Scientific Association for Probiotics and Prebiotics. Please see the full study for all other authors’ relevant financial disclosures.

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