Preschoolers given a daily probiotic for three
months had markedly fewer respiratory infections and bouts of
diarrhea compared to classmates taking a placebo, according to the
trial results published in Pediatrics.
Dr. Pedro Gutierrez-Castrellon, who led the study, said probiotics
are a promising line of research in the field of pediatric
Children in daycare centers are at increased risk of both
gastrointestinal and respiratory illness. Probiotics are "friendly"
bacteria thought to benefit the immune system and digestion.
Often available over the counter, probiotics can come in capsules,
drops or incorporated into foods like yogurt.
For the study, Gutierrez-Castrellon, a researcher with the National
Perinatology Institute in Mexico City, and his colleagues tested a
friendly-bacteria strain called Lactobacillus reuteri DSM 17938 in
four daycare centers in Mexico City.
"When we analyzed the field of probiotics in pediatrics, we identify
L. reuteri as one of the strongest type of probiotics for use in
children," Gutierrez-Castrellon said.
He added that it's better to use a single strain of probiotic
bacteria than multiple strains, so they focused their study on L.
Gutierrez-Castrellon and colleagues enrolled a total of 336 children
ages six months to three years in the study and followed each child
for six months.
Half the children were given eight probiotic drops daily for three
months, while the other half were given a placebo treatment — identical drops containing no probiotics.
Parents and caregivers recorded any episodes of diarrhea or
respiratory symptoms for the three months the children were given
the drops and for the three months after the drops were
During the first three months, there were a total of 42 episodes of
diarrhea with an average duration of 1.4 days among kids who got the
probiotics. The children in the placebo group had 69 diarrhea
episodes that lasted, on average, 2.5 days.
Respiratory tract symptoms totaled 93 reports among kids in the
probiotic group compared to 204 reports in the placebo group.
The differences in illness rates endured after the children stopped
taking the probiotics. During the three-month follow-up, there were
57 reports of diarrhea in the treatment group compared to 83 in the
placebo group and 129 reports of respiratory symptoms compared to
197 in the placebo group.
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The researchers also found the children in the treatment group
used antibiotics less during the study. When they calculated the
total costs of illnesses, including medical visits, rehydration
solutions and all types of drug treatments, they linked probiotic
use to cost savings of $36 per episode of diarrhea and $37 per case
of respiratory tract infection.
The study was funded by BioGaia AB, Stockholm, Sweden, which also
provided the L. reuteri probiotic used in the research.
Roger Clemens told Reuters Health the study validates and
reinforces previous studies on probiotic use in young children.
"I think this is critical from a public health perspective in
daycare centers where we have a high increase of diarrheal disease
because kids pass everything around," he said. "The kids go to
daycare centers and bring it home and mom and dad get sick — so they
share that a lot."
Clemens, who was not involved in the study, is a researcher and
associate director of the regulatory science program at the
University of Southern California School of Pharmacy in Los Angeles.
He added that studying specific strains of probiotics at specific
doses for specific outcomes is important, and he believes L. reuteri
is a potent strain of probiotic.
"If you take it on a regular basis you can reduce the risk of all
kinds of conditions that can happen in the GI tract as well — it's
pretty powerful," he said.
With the large number of probiotics available, it's difficult for
parents to know which probiotics to use without doing a little
Clemens said that pharmacists should know which probiotics are best,
but that parents can also read labels on the products for additional
Pediatrics, online March 17, 2014.
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