There is growing evidence encouraging the use of probiotics in many conditions in children. However, given the wide number of probiotics available and contradictory data in the literature, the health-care provider is often faced with uncertainness about whether or not to use probiotics and which one(s) to choose. We here review current hypotheses regarding the efficacy and safety of probiotics and evaluate the available data on the use of probiotics in most common diseases in children. Considering that probiotics have strain-specific effects, we will focus on individual probiotic strains rather than on probiotics in general.
Strain-specific efficacy was clearly demonstrated with Lactobacillus rhamnosus GG and Saccharomyces boulardii I-745 in the treatment of acute infectious diarrhea, Lactobacillus reuteri DSM 17938 in infantile colics, Lactobacillus rhamnosus GG, and VSL#3 in irritable bowel syndrome. In addition, encouraging results are seen for use of probiotics in necrotizing enterocolitis, food allergy, and nonalcoholic fatty liver disease. However, the data available for constipation are to be considered somewhat equivocal.
The clinical relevance of these findings indicates that healthcare providers need to take strain-specificity and disease specificity of probiotics into consideration when recommending probiotic for their patients.
aPaediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII Bergamo
bDepartment of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa
cDepartment of Medicine, University of Verona, Verona
dDepartment of Pediatrics, Sapienza University of Rome, Roma
eDepartment of Pediatrics, Ospedale Santobono, Napoli
fNational Health System Pediatrician, Coordinator Microbiota Committee SIAIP, Rome, Italy
Correspondence to Naire Sansotta, Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII Bergamo, Bergamo, Italy. E-mail: firstname.lastname@example.org