Probiotics and otitis media in children

Objective: An alternative option in the prophylaxis and the management of infectious diseases is the use of probiotics, which are known to stabilize gut microbiota and stimulate immune function. Otitis media (OM) is the most common bacterial infection in childhood. The aim of this review is to present the current knowledge of the effects of probiotics on OM. Methods: A PUBMED search was made to review the relevant literature, and publications on probiotics and otitis media in children were included. Additional studies were obtained from the references of the selected articles. Results: Only a few studies using different probiotic strains and study populations have investigated the effects of probiotics on OM. Five studies investigating the effects of oral probiotics, and three studies investigating the effect of probiotic nasal spray treatment were included in this review. Oral probiotics have reduced the incidence of OM in healthy children in one of two studies (days with OM: probiotic 0.5 vs. control 1.0; p = 0.003) and in newborns in one of two studies (incidence of OM: probiotic 22%, placebo 50%; p = 0.014), but has had no effect on OM in one study in otitis prone children. Nasal spray treatment containing alpha streptococci has led to clinical improvement in children with recurrent or secretory OM in two of three studies (cured: probiotic 42% vs. placebo 22%, p = 0.02; recovery: probiotic 7/19 patients vs. placebo 1/17, p < 0.05). Conclusions: Although there are some promising results, the lack of confirmative studies makes it difficult to draw any conclusions. More studies are needed to identify the most promising probiotic strains and study populations, and to evaluate the mechanisms behind the possible effects of probiotics on OM. (C) 2012 Elsevier Ireland Ltd. All rights reserved.