A recent review showed that the administration of mixed strains of bacteria is beneficial to the treatment of eczema. However, evidence of its efficacy is less conclusive in infants.
Therefore researchers in China assessed the outcomes of seven studies, which examined 609 children aged under three years.
Writing in the International Journal of Dermatology, they stated: “To the best of our knowledge, this is the first meta-analysis focusing on the treatment effect of probiotics in infants. In the current meta-analysis, we found a significant effect of probiotics in the management of infantile [eczma].”
Subgroup analysis found that Lactobacillus strains appeared to be particularly protective in the treatment of the condition.
However, only three studies, involvingaccruing 148 subjects for the treatment and the control group combined, investigated the effect of Bifidobacterium species.
“As such, results of Bifidobacterium should be viewed with caution due to the smaller size and heterogeneity of studies. It might be fruitful to further explore the effect of bifidobacteria in combination with Lactobacillus or alone in larger trials,” they added.
Severity and age key
The study also found that disease severity was associated with the effect of probiotic treatment, with the more severe the condition, the greater the impact.
“In infants with moderate-to-severe diseases, we observed a significantly protective effect, whereas in participants with milder diseases, the effect was not significant, which was in accordance with previous meta-analysis where older children were studied,” they noted.
Another key finding was that probiotic treatment might be more effective in infants aged less than 12 months.
“One possible explanation is that children of one year of age or less are less subjective to other dietary supplements, which at older ages might become allergens and contribute to exacerbation,” wrote the researchers.
They added that more research was required to assess safety profile of probiotic treatment, arguing that incidents of common side effects, including constipation, nausea, infection, and rash, were infrequently registered in studies.
Nevertheless, they concluded: “The current analysis favors the employment of probiotics in children. However, caution should be raised when treating children less than one year of age. Moreover, mild subjects constitute exceptions of this beneficial effect.
“More studies investigating efficacy of Bifidobacterium strains could be informative. Also, further larger studies are needed to address the safety, dose-response profile, and long-term effect of probiotics in the treatment of paediatric [eczema].”
The relationship between infant gut microbiota and allergies is a growing area of interst for researchers. One recent study, backed by Danone, found "pronounced differences in intestinal microbiota composition between allergic and healthy infants" at three months of age.
Source: International Journal of Dermatology
"Treatment efficacy of probiotics on atopic dermatitis, zooming in on infants: a systematic review and meta-analysis"
Authors: Mutong Zhao M, et al.