Efficacy of probiotics in the treatment of pediatric atopic dermatitis: a meta-analysis of randomized controlled trials

Background: Several articles describing the efficacy of probiotics in atopic dermatitis (AD) have been published. However, not all studies support a similar outcome. Objective: To determine whether probiotics are efficacious in treating AD and to explore whether type of probiotic used, duration of therapy, patient age, severity of disease, and I-E sensitization are factors in determining efficacy. Methods: For this meta-analysis of randomized controlled trials describing the efficacy of probiotics in AD, a comprehensive search was performed of databases through January 2008. Three reviewers independently evaluated the Studies for methodological qualities. All the data were analyzed, and forest plots were evaluated for the overall efficacy of probiotics in AD and the therapeutic benefit to subgroups of selected patient populations. Results: Eleven studies were identified, and data from 10 studies (n = 678) were available to analyze. There was an overall statistically significant difference favoring probiotics compared with placebo in reducing the Scoring of Atopic Dermatitis Severity Index score (mean change from baseline, -3.01; 95% confidence interval, -5.36 to -0.66; P =.01). Children with moderately severe disease were more likely to benefit. Duration of probiotic administration. age, and type of probiotic used did not affect outcome. Conclusion: Data from this meta-analysis suggest a modest role for probiotics in pediatric AD. The effect is seen in moderately severe rather than mild disease.