Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Feb 1;76(2):227-231.
doi: 10.1097/MPG.0000000000003675. Epub 2022 Dec 1.

Strain-Specificity of Probiotics in Pediatrics: A Rapid Review of the Clinical Evidence

Mateusz Jankiewicz  1 , Jan Łukasik, Maja Kotowska, Maciej Kołodziej, Hania Szajewska
Affiliations
Review

Strain-Specificity of Probiotics in Pediatrics: A Rapid Review of the Clinical Evidence

Mateusz Jankiewicz et al. J Pediatr Gastroenterol Nutr. .

Abstract

Objective: The dogma of probiotic strain-specificity is widely accepted. However, only the genus- and species-specific effects of probiotics are supported by evidence from clinical trials. The aim of this rapid review was to assess clinical evidence supporting the claim that the efficacy of probiotics in the pediatric population is strain-specific.

Methods: The Cochrane Library, MEDLINE, and EMBASE databases were searched (up to August 2022) for randomized controlled trials (RCTs) conducted in children aged 0-18 years evaluating the effects of prophylactic or therapeutic administration of probiotics (well-characterized at the strain level) for conditions such as antibiotic-associated diarrhea, acute diarrhea, necrotizing enterocolitis, respiratory tract infections, Helicobacter pylori infection, and atopic dermatitis. To allow evaluation of strain-specificity, a trial could only be included in the review if at least one additional RCT assessed the effect of a different strain of the same species against the same comparator. RCTs without proper strain-level data were excluded. In the absence of identifying head-to-head strain versus strain RCTs, indirect comparisons were made between interventions.

Results: Twenty-three RCTs were eligible for inclusion. Out of the 11 performed comparisons, with 1 exception (two Lacticaseibacillus paracasei strains in reducing atopic dermatitis symptoms), no significant differences between the clinical effects of different strains of the same probiotic species were found.

Conclusions: Head-to-head comparison is an optimal study design to compare probiotic strains, but such comparisons are lacking. Based on indirect comparisons, this rapid review demonstrates insufficient clinical evidence to support or refute the claim that probiotic effects in children are strain-specific.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Hill C, Guarner F, Reid G, et al. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11:506–14.
    1. Draper K, Ley C, Parsonnet J. A survey of probiotic use practices among patients at a tertiary medical centre. Benef Microbes. 2017;8:345–51.
    1. Fijan S, Frauwallner A, Varga L, et al. Health professionals’ knowledge of probiotics: an international survey. Int J Environ Res Public Health. 2019;16:312817.
    1. Szajewska H, Canani RB, Domellöf M, et al. Probiotics for the management of pediatric gastrointestinal disorders: position paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications. J Pediatr Gastroenterol Nutr. 2022.
    1. Tan-Lim CSC, Esteban-Ipac NAR, Mantaring IJ, et al. Comparative effectiveness of probiotic strains for the treatment of pediatric atopic dermatitis: a systematic review and network meta-analysis. Pediatr Allergy Immunol. 2021;32:124–36.

Substances