Skriv ut

Probiotika kan hjälpa barn mot luftvägsinfektioner

15 september 2009.

En dubbelblind, placebokontrollerad studie har nyligen visat att så kallade probiotika, dvs nyttiga laktobaciller i hälsodryck och vissa yoghurtprodukter, kan hjälpa barnens immunförsvar att motstå förkylningar och influensaliknande luftvägsinfektioner. I studien ingick 326 friska barn mellan 3-5 år som antingen fick  placebo, Lactobacillus acidophilus eller Lactobacillus acidophilus i kombination med Bifidobacterium animalis två gånger dagligen i 6 månader. Studieresultaten är väldigt lovande och visade en klar reduktion av infektionsrelaterade symtom såsom feber, hosta, snuva och skolfrånvaro i de aktivt behandlade grupperna.

Probiotics May Be Useful Against Colds, Flu-Like Symptoms in Children CME/CE

MEDSCAPE - August 12, 2009 - Probiotics may be useful as prophylaxis against cold and influenza-like symptoms in children, according to the results of a double-blind, placebo-controlled study reported in the August issue of Pediatrics.

"Selected strains of probiotics have been tested for human health benefits in a variety of disease conditions, but much less is known regarding prophylactic benefits in healthy populations," write Gregory J. Leyer, PhD, from Danisco in Madison, Wisconsin, and colleagues. "This study adds information supporting the use of the probiotics tested for prophylaxis against cold and influenza-like symptoms and compares the efficacy of 1-strain and 2-strain preparations."

The effects of probiotic intake on incidence and duration of cold and influenza-like symptoms during the winter season were evaluated in healthy children aged 3 to 5 years. Of 326 eligible children, 104 were randomly assigned to receive placebo, 110 to Lactobacillus acidophilus NCFM, and 112 to L acidophilus NCFM in combination with Bifidobacterium animalis subsp lactis Bi-07. Children were treated twice daily for 6 months.

Compared with the placebo group, the groups receiving single and combination probiotics fared significantly better in several outcomes. Fever incidence was 53.0% lower with single probiotics (P = .0085) and 72.7% lower with combination probiotics (P = .0009); coughing incidence, 41.4% (P = .027) and 62.1% (P = .005) lower; and rhinorrhea incidence, 28.2% (P = .68) and 58.8% (P =.03) lower, respectively.

Fever, coughing, and rhinorrhea duration were 32% lower with single strain vs placebo (P = .0023) and 48% lower with the strain combination (P < .001). Antibiotic use incidence was 68.4% lower for single strain vs placebo (P = .0002) and 84.2% lower for strain combination (P < .0001). Days absent from group child care were also 31.8% lower for single strain vs placebo (P =.002) and 27.7% lower for the strain combination (P < .001).

"Daily dietary probiotic supplementation for 6 months was a safe effective way to reduce fever, rhinorrhea, and cough incidence and duration and antibiotic prescription incidence, as well as the number of missed school days attributable to illness, for children 3 to 5 years of age," the study authors write. "No notable adverse events were attributed to study probiotic strains."

Limitations of this study include failure to evaluate mucosal colonization, underlying mechanisms, or the effect of probiotics in an acute response to signs of illness.

"Daily probiotic dietary supplementation during the winter months was a safe effective way to reduce episodes of fever, rhinorrhea, and cough, the cumulative duration of those symptoms, the incidence of antibiotic prescriptions, and the number of missed school days attributable to illness," the study authors conclude. "L acidophilus NCFM alone was effective. There was, however, a trend for a broader protective effect with the combination of L acidophilus NCFM and B lactis Bi-07."

Pediatrics. 2009;124:e172-e179.

Clinical Context

The use of probiotics for disease prevention in addition to disease treatment is under investigation. In the June 2, 2001, issue of the BMJ, Hatakka and colleagues reported that Lactobacillus use in children in day care centers had no significant effect on the incidence of infection. In the January 2005 issue of Pediatrics, Weizman and colleagues found that L reuteri and B animalis subsp lactis Bb-12 use were linked with a lower incidence of fever, but not of respiratory tract symptoms.

This prospective, double-blind, placebo-controlled study evaluates the effect of L acidophilus NCFM alone or in combination with B animalis subsp lactis Bi-07 on the incidence of fever, rhinorrhea, and cough, the duration of symptoms, the incidence of antibiotic use, school absences, and clinician visits.

 

Study Highlights

 

  • 326 healthy children (aged 3 - 5 years) in the People's Republic of China were randomly assigned to receive placebo, L acidophilus NCFM alone, or L acidophilus with B animalis subsp lactis twice daily for 6 months.
  • Inclusion criteria were no known preexisting diseases, anatomic anomalies, contraindications to dairy products, inflammatory disease, intestinal disease, chronic cough, cystic fibrosis, or functional gastrointestinal tract conditions.
  • Exclusion criterion was probiotic use.
  • 104 patients received sucrose placebo.
  • 110 patients received 1.0 x 1010 colony-forming units per gram of L acidophilus total per day added to 1% fat milk.
  • 112 patients received 50% L acidophilus NCFM plus 50% B animalis subsp lactis for a total of 1.0 x 1010 colony-forming units per gram total per day in 1% fat milk.
  • Placebo subjects were 4 to 5 months older than subjects receiving L acidophilus NCFM and those receiving L acidophilus NCFM combined with B animalis subsp lactis (P < .001).
  • Participants were instructed not to use traditional Chinese medicine during the study.
  • Participants did not receive influenza vaccination.
  • Symptom questionnaires were completed by group child care center representatives during weekdays and by patients' guardians during weekends.
  • Fever incidence was reduced with single probiotic vs placebo (decrease, 53.0%; P =.0085; odds ratio [OR], 0.57; 95% confidence interval [CI], 0.44 - 0.90; P = .015).
  • Fever incidence was reduced with combined probiotic vs placebo (decrease, 72.7%; P = .0009; OR, 0.34; 95% CI, 0.22 - 0.63; P = .01).
  • Cough incidence was reduced with single probiotic vs placebo (decrease, 41.4%; P = .027; OR, 0.59; 95% CI, 0.39 - 0.96; P = .028).
  • Cough incidence was reduced with combined probiotic vs placebo (decrease, 62.1%; P = .005; OR, 0.44; 95% CI, 0.28 - 0.78; P = .005).
  • Rhinorrhea incidence was reduced with combined probiotic vs placebo (decrease, 58.8%; P = .03; OR, 0.52; 95% CI, 0.34 - 0.97; P = .04).
  • Rhinorrhea incidence was reduced with single use vs placebo (decrease, 28.2%; P = .68).
  • Age-adjusted duration of symptoms decreased with single probiotic vs placebo (-2.17 days; P = .0023).
  • Age-adjusted duration of symptoms decreased with combined probiotic vs placebo (-3.2 days; P < .001).
  • Antibiotic use incidence decreased with single probiotic use by 68.4% (P = .0002) and with combined probiotic use by 84.2% (P < .0001) vs placebo.
  • Absences from group child care reduced with single probiotic vs placebo (-1.6 days; P = .01) and with combined probiotic vs placebo (-1.4 days; P = .01).
  • Clinician visits were not significantly different between the groups.
  • There were no significant differences in results between single and combined probiotic use.
  • Vomiting and diarrhea incidences were too low to be affected by probiotic use.
  • The number of subjects who withdrew from the study was similar for all groups.

Clinical Implications

  • In children, L acidophilus NCFM treatment alone results in a lower incidence of fever and cough, whereas combined L acidophilus NCFM and B animalis subsp lactis results in a lower incidence of fever, cough, or rhinorrhea. L acidophilus NCFM alone or in combination with B animalis subsp lactis results in shorter duration of symptoms.
  • Children who receive L acidophilus NCFM alone or in combination with B animalis subsp lactis have lower incidence of school absences and antibiotic use, but not clinician visits

Hälsoprofil och hälsokontroll

halsoprofil

Medicinsk Qigong

qigong

Ljusterapi

ljusterapi

Screening

screening