Atopic dermatitis and skin diseaseProbiotics for the prevention of allergy: A systematic review and meta-analysis of randomized controlled trials
Section snippets
Types of studies
We included randomized controlled trials with a minimum follow-up of 4 weeks that compared any type of probiotic with placebo, irrespective of their language or publication status.
Types of participants
Studies must have included 1 or more of the following groups of participants: pregnant women, breast-feeding mothers, and infants and children. We included studies that assessed the use of probiotics in any age group, from newborn infants to preschool and school-age children (up to 9 years of age).
Types of interventions
We included studies
Results
Our search strategy identified 2403 unique bibliographic citations, of which 178 were selected for full-text assessment (Fig 1). We identified 29 randomized controlled trials comparing at least 1 probiotic with placebo18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46 and meeting the inclusion criteria. Fig 2 lists the included studies according to the different populations and periods when the probiotics were administered (eg,
Discussion
In this systematic review we found that supplementation with probiotics during pregnancy, in breast-feeding mothers, or in infants decreases the risk of eczema (including atopic eczema) in infants. However, the certainty in the evidence is very low because of the risk of bias across trials, indirectness of the evidence, inconsistency of results among studies, and imprecision of the pooled estimates. Currently available evidence suggests that supplementation of probiotics does not reduce the
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Supported by the World Allergy Organization.
Disclosure of potential conflict of interest: This study was supported by the World Allergy Organization (WAO). The institution of J. L. Brożek, A. Fiocchi, J. J. Yepes-Nuñez, L. Terracciano, S. Gandhi, C. A. Cuello-Garcia, Y. Zhang, and H. J. Schünemann, has received consultancy fees from the WAO, as well as support for travel to meetings and other study-related purposes and fees for participating in review activities. A. Fiocchi has received consultancy fees from GlaxoSmithKline, as well as payment for delivering lectures from Danone. R. Pawankar received royalties from Springer and is employed by the Nippon Medical School in Tokyo, Japan, which has received or has grants pending from the Japanese Ministry of Education. L. Terracciano has received consultancy fees from Heinz-Plada. The rest of the authors declare that they have no relevant conflicts of interest.