Regular use of probiotics in infants and children can significantly reduce the need for an antibiotic treatment during childhood, according to a new review of studies published in the European Journal of Public Health. These findings, authors say, may contribute in the future to mitigate the rise of antibiotic resistance, a global health threaten.
The review looked over 17 previously published studies assessing the impact of a whole range of different probiotics on incidence and duration of common infectious diseases of the respiratory and digestive tracts in children; 12 of the 17 studies assessed the antibiotic use during these infections.
It appears that taking probiotics daily reduced prescription of antibiotics in those children by 29% compared to those who received a placebo. Moreover, when they reviewed only the five highest quality studies, the percentage rose up to 53%.
“Taken together, the studies we included in this analysis demonstrated that probiotic supplementation is more effective than placebo for reducing the incidence or duration of certain illnesses: acute respiratory tract infections, acute digestive tract infections, and acute ear infections”, says co-author Dr Andi Shane, researcher at Emory University School of Medicine (Atlanta, USA).
“This analysis shows that, in addition to those advantages [reducing the incidence and duration of those illnesses], probiotic supplementation may reduce the use of antibiotics”, adds Shane.
The exact mechanisms, though, explaining the probiotic-linked drop of antibiotic usage are still unknown. But authors hypothesise that taking into account that 75% of our immune system is located in the gut maybe the consumption of healthy bacteria -probiotics- could lead to strengthen the immune system so that it combats more efficiently pathogens. Or maybe it could lead to the competitive inhibition of the growth of gut pathogens.
Nowadays, antibiotic resistance is an urgent public health menace worldwide. Although the efforts to raise awareness on antimicrobial resistance, there is still a high prevalence of misuse and abuse of antibiotic consumption.
“Potentially one way to reduce the use of antibiotics is to use probiotics on a regular basis,” says the study’s senior investigator, Daniel Merenstein, a professor in the Department of Family Medicine at Georgetown University School of Medicine (Washington, DC), who is part of the team led by Sarah King, the main author of this article.
“We already have evidence that consuming probiotics reduces the incidence, duration, and severity of certain types of common acute respiratory and gastrointestinal infections,” Merenstein adds.
According to this author, the question, before they did the current analysis, was to assess whether the reduction of the symptoms of some diseases was solidly linked to a decrease in the use of antibiotics; in that case, it would demonstrate the health benefits were due to probiotics and not antibiotics. And “we see that there is an association,” claims Merenstein.
As the review only examined previous research in infants and children and that some of those were not homogeneous, authors insist that follow-up studies are needed in all age groups to make recommendations on the type and dose of probiotics needed to be effective.
Sarah King, Daniel Tancredi, Irene Lenoir-Wijnkoop, et al. Does probiotic consumption reduce antibiotic utilization for common acute infections? A systematic review and meta-analysis. European Journal of Public Health, 2018. DOI: https://doi.org/10.1093/eurpub/cky185
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