A multi-strain Synbiotic may reduce viral respiratory infections in asthmatic children: a randomized controlled trial

Abstract

Background and objectiveAsthma is a growing problem worldwide. Acute exacerbations impose considerable morbidity, mortality, and increased cost. Viral respiratory infections are the most common cause (80–85%) of pediatric asthma exacerbations and admissions to the hospital. The aim of this study was to determine the effect of a new synbiotic Lactocare® on viral respiratory infections and asthma exacerbations in asthmatic children.MethodsIn this double blind, placebo-controlled, randomized clinical trial, 72 children with mild persistent asthma, aged between 6 and 12 years, were randomized to receive either Lactocare®, a Synbiotic containing 1 billion CFU/Capsule of Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium infantis, Lactobacillus bulgaricus, and Fructooligosacharide (Zist Takhmir, Tehran, Iran) or placebo daily for 60 days. The primary outcome was the number of viral respiratory infections, and secondary outcomes were school absence, salbutamol and prednisolone usage, outpatient visits, and hospital admission for asthma. The outcomes were compared among study groups using the SPSS 11.5 program and the Mann Whitney and Fisher exact tests.ResultsOf the 72 children who were enrolled with mild persistent asthma, 36 were assigned randomly to be treated with synbiotic and 36 with placebo. The number of viral respiratory infections was significantly higher in placebo group than the synbiotic group during the first month of intervention (0.74 ± 0.12 vs. 0.44 ± 0.1, p < 0.007) but not during the second month (0.5 ± 0.8 vs. 0.5 ± 0.8, p < 0.641). Considering the total duration of the study (two months), infection episodes also were significantly lower in the synbiotic group (0.92 ± 0.15 vs. 0.69 ± 0.11, p < 0.046). Salbutamol consumption was significantly lower in the synbiotic group, but there were no significant differences in school absenteeism, oral prednisolone use, outpatient visits, or hospital admissions.ConclusionThis new synbiotic (a mixture of seven probiotic strains plus fructooligosacharide may reduce episodes of viral infection in asthmatic children.Trial registrationThis study is registered in Iranian Registry of Clinical Trials with registration number of IRCT201509234976N3.FundingThis research was supported financially by the Research Council of Mashhad University of Medical Sciences (Grant Number: 911048).

Probiotics supplementation in children with asthma: A systematic review and meta‐analysis

“…There may be side effects of probiotics in patients with critical illness or bone marrow/stem cell transplantation . One included study reported that probiotics might not significantly increase the incidence of fever and diarrhoea . Among all included RCTs, rare cases of severe complications occurred, with a certain association with probiotics consumption.…”

“…The results of the use of bronchodilators were inconsistent in different studies. Two studies 12,16 showed that the frequency was statistically reduced after probiotics supplementation. However, Rose et al 17 indicated that there was no significant difference when using inhalative betamimetics during the daytime in two arms.…”

“…Risk of bias of the included studies was assessed according to the Cochrane Handbook. Five studies [12][13][14][15]19 reported adequate methods in random sequence generation. None reported the adequate method of allocation concealment.…”

“…Recent meta‐analyses revealed the benefits of probiotics in the treatment of allergic rhinitis and dermatitis . Previous clinical trials were conducted to explore the effects of probiotic supplementation on asthmatic children; nevertheless, the results were inconsistent . There was no systematic review of probiotics supplementation for asthmatic children.…”

“…[8][9][10][11] Previous clinical trials were conducted to explore the effects of probiotic supplementation on asthmatic children; nevertheless, the results were inconsistent. [12][13][14][15][16][17][18][19][20][21][22] There was no systematic review of probiotics supplementation for asthmatic children. In view of the lack of evidence-based review, we aimed to assess the effects of probiotics on asthmatic children in this systematic review and metaanalysis of currently available randomised control trials (RCTs).…”