Abstract
Recent systematic reviews have reported a positive, although modest, effect of probiotics in terms of preventing common cold symptoms. In this systematic review, the effect of probiotics, specifically Lactobacillus and Bifidobacterium strains, on the duration of acute respiratory infections in otherwise healthy children and adults was evaluated. To identify relevant trials, eight databases, including MEDLINE, Embase, the Cochrane Database of Systematic Reviews (CDSR), the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA), Science Citation Index (SCI) and OAISTER, were searched from inception to 20 July 2012. Details regarding unpublished studies/databases were also obtained from probiotic manufacturers. Study selection, data extraction and quality assessment were carried out by two reviewers. Risk of bias was assessed using criteria adapted from those published by the Centre for Reviews and Dissemination. In this review, twenty randomised controlled trials (RCT) were included, of which twelve were considered to have a low risk of bias. Meta-analysis revealed significantly fewer numbers of days of illness per person (standardised mean difference (SMD) - 0·31 (95% CI - 0·41, - 0·11), I²= 3%), shorter illness episodes by almost a day (weighted mean difference - 0·77 (95% CI - 1·50, - 0·04), I²= 80%) (without an increase in the number of illness episodes), and fewer numbers of days absent from day care/school/work (SMD - 0·17 (95% CI - 0·31, - 0·03), I²= 67%) in participants who received a probiotic intervention than in those who had taken a placebo. Reasons for heterogeneity between the studies were explored in subgroup analysis, but could not be explained, suggesting that the effect sizes found may differ between the population groups. This systematic review provides evidence from a number of good-quality RCT that probiotics reduce the duration of illness in otherwise healthy children and adults.
Highlights
Recent systematic reviews have reported a positive, modest, effect of probiotics in terms of preventing common cold symptoms
The results demonstrated that there was a significant difference in favour of probiotics, suggesting fewer numbers of days absent from day care/school/work compared with that in participants who had taken a placebo (SMD 20·17, P1⁄40·02)
We identified a number of studies that evaluated the effectiveness of probiotics on the duration of illness episodes
Summary
Recent systematic reviews have reported a positive, modest, effect of probiotics in terms of preventing common cold symptoms. The effect of probiotics, Lactobacillus and Bifidobacterium strains, on the duration of acute respiratory infections in otherwise healthy children and adults was evaluated. This systematic review provides evidence from a number of good-quality RCT that probiotics reduce the duration of illness in otherwise healthy children and adults. Several studies(5–8) have evaluated the effectiveness of probiotics on the symptoms and incidence of common infectious respiratory diseases. Recent meta-analyses(9,10) have reported a positive, modest, effect of probiotics in terms of preventing common cold symptoms. The objective of this systematic review was to assess the effect of probiotics on the duration of an acute RTI in otherwise healthy children and adults. For the purposes of this review, ‘probiotic’ hereafter refers to Lactobacillus and Bifidobacterium strains
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