Effectiveness of the probiotic Streptococcus salivarius K12 for the treatment and/or prevention of sore throat: a systematic review

Abstract

Background: Sore throat resulting from pharyngotonsillitis is one of the commonest reasons for primary care consultation and inappropriate antibiotic prescription and finding effective alternative treatments is important. Objectives: To review the evidence for using the probiotic Streptococcus salivarius K12 (SsK12) for the prevention or treatment of pharyngotonsillitis. Data Sources: PubMed, Embase, CINAHL and Cochrane Library. Study eligibility criteria: Randomized controlled trials (RCTs). Participants: Adults or children. Interventions: SsK12 as active treatment or prophylaxis, against pharyngotonsillitis. Methods: Literature search. Results: Four articles were identified (1846 participants). All were deemed to be of poor quality using the Cochrane risk-of-bias assessment. Two trials studied SsK12 prophylaxis for streptococcal pharyngitis (children without history of recurrence). One compared daily administration of SsK12 to no treatment over 6 months (n ¼ 222, age 33e45 months), reporting significantly lower incidence in the SsK12 group (16.2% vs. 48.6%, p < 0.01), whereas another placebo-controlled RCT over four school terms (n ¼ 1314, 5 e14 years) found no significant difference (7.8% vs. 8.8%, p 0.34) with SsK12 (administered on school days). Another trial found daily SsK12 to significantly protect children (n ¼ 250, 6e7 years) against chronic adenoiditis exacerbation over 3 months compared to no treatment (71.7% vs. 100%, p < 0.0001). The one placebo-controlled RCT in adults that studied the use of SsK12 for acute pharyngotonsillitis (concurrently with penicillin) showed no significant benefit. In all trials, SsK12 was safe and well tolerated.Conclusions: SsK12 appears safe and well tolerated. However, further RCTs are required to establish its role as a prophylactic therapy, particularly among patients experiencing frequent exacerbations of pharyngitis. In the acute setting, SsK12 is unlikely to be effective if given concurrently with antibiotics; however, further RCTs should establish its role as an alternative to antibiotics in nonsevere cases or when prescribed after antibiotic therapy for the prevention of disease recurrence and/or secondary infection.

The Fatty-Acid Hydratase Activity of the Most Common Probiotic Microorganisms

“…To complete our strain selection, we investigated the hydratase activity of two further bacteria, namely Bacillus coagulans (Colinox ® ) and Streptococcus salivarius (ATCC BAA 1024) as well as that of Saccharomyces boulardii (SB80 ® , CNCM I-3799), which is the only yeast widely used as a probiotic. All these microorganisms are commercially available because they are currently used to restore the gut and oral cavity flora and thus improve human health [43][44][45][46][47][48][49][50][51][52][53][54][55].…”

Lactobacillus commensals autochthonous to human milk have the hallmarks of potent probiotics

“…Antagonism towards S. pyogenes by some lactobacillus species is seen as a possible alternative to antibiotherapy for acute pharyngitis [74, 75], commonly reported in the local population [76]. It results in part from the production of organic acids and bacteriocins, but the ability to produce H 2 O 2 is another important mechanism of bacterial antagonism.…”

New probiotic strain Streptococcus salivarius K12 in clinical practice

“…В январском номере журнала Clinical Microbiology and Infection за 2019 г. был опубликован систематический обзор, целью которого была оценка имеющихся доказательств эффективности использования пробиотика S. salivarius K12 для профилактики или лечения тонзиллофарингита [34]. Было идентифицировано 4 публикации с общим количеством участников 1846.…”