RESUMO
ABSTRACT OBJECTIVES: Evaluate the effect of probiotics on the symptoms, duration of disease, and the occurrence of new episodes of upper and lower respiratory infections in healthy children. SOURCES: In order to identify eligible randomized controlled trials, two reviewers accessed four electronic databases [MEDLINE/PubMed, Scopus (Elsevier), Web of Science, and Cochrane (Cochrane VHL)], as well as ClinicalTrials.gov until January 2015. Descriptors were determined by using the Medical Subject Headings tool, following the same search protocol. SUMMARY OF THE FINDINGS: Studies showed to be heterogeneous regarding strains of probiotics, the mode of administration, the time of use, and outcomes. The present review identified 11 peer-reviewed, randomized clinical trials, which analyzed a total of 2417 children up to 10 incomplete years of age. In the analysis of the studies, reduction in new episodes of disease was a favorable outcome for the use of probiotics in the treatment of respiratory infections in children. It is noteworthy that most of these studies were conducted in developed countries, with basic sanitation, health care, and strict, well-established and well-organized guidelines on the use of probiotics. Adverse effects were rarely reported, demonstrating probiotics to be safe. CONCLUSIONS: Despite the encouraging results - reducing new episodes of respiratory infections - the authors emphasize the need for further research, especially in developing countries, where rates of respiratory infections in children are higher when compared to the high per capita-income countries identified in this review.
RESUMO OBJETIVOS: Avaliar o efeito do uso de probióticos na redução dos sintomas, da duração da doença e da ocorrência de novos episódios de infecções respiratórias superior e inferior em crianças saudáveis. FONTES DE DADOS: Com a finalidade de identificar ensaios clínicos randomizados elegíveis, dois revisores acessaram quatro bases de dados eletrônicas (Medline/PubMed, Scopus [Elsevier], Web of Science e Cochrane [The Cochrane Library]), além do ClinicalTrials.gov, até janeiro de 2015. Foram usados descritores, por meio da ferramenta Medical Subject Headings, e foi seguido um mesmo protocolo de busca. SÍNTESE DOS DADOS: Os estudos apresentaram grande heterogeneidade em relação às cepas de probióticos, à forma de administração, ao tempo de uso e aos desfechos. Identificamos 11 ensaios clínicos randomizados, revisados por pares, que analisaram 2.417 crianças até 10 anos incompletos. Na análise dos estudos, redução de novos episódios de doença foi o desfecho favorável ao uso dos probióticos no tratamento das infecções respiratórias na criança. Importante salientar que essas pesquisas foram feitas, em sua maioria, em países desenvolvidos, com condições de saneamento, de assistência à saúde e de regulamentação rigorosa ao uso de probióticos bem estabelecidos e organizados. Quanto aos efeitos adversos, pouco relatados, configuram os probióticos como seguros. CONCLUSÕES: Apesar do resultado encorajador - redução de novos episódios de infecções respiratórias - destacamos a necessidade de pesquisas futuras, principalmente em países em desenvolvimento, onde as taxas de infecções respiratórias na criança são maiores quando comparadas com as dos países de elevada renda per capita identificados nesta revisão.
Assuntos
Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Probióticos/uso terapêutico , Infecções Respiratórias/terapia , Viés , Países Desenvolvidos , Probióticos/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Recidiva , Infecções Respiratórias/epidemiologia , Fatores de TempoRESUMO
OBJECTIVES: Evaluate the effect of probiotics on the symptoms, duration of disease, and the occurrence of new episodes of upper and lower respiratory infections in healthy children. SOURCES: In order to identify eligible randomized controlled trials, two reviewers accessed four electronic databases [MEDLINE/PubMed, Scopus (Elsevier), Web of Science, and Cochrane (Cochrane VHL)], as well as ClinicalTrials.gov until January 2015. Descriptors were determined by using the Medical Subject Headings tool, following the same search protocol. SUMMARY OF THE FINDINGS: Studies showed to be heterogeneous regarding strains of probiotics, the mode of administration, the time of use, and outcomes. The present review identified 11 peer-reviewed, randomized clinical trials, which analyzed a total of 2417 children up to 10 incomplete years of age. In the analysis of the studies, reduction in new episodes of disease was a favorable outcome for the use of probiotics in the treatment of respiratory infections in children. It is noteworthy that most of these studies were conducted in developed countries, with basic sanitation, health care, and strict, well-established and well-organized guidelines on the use of probiotics. Adverse effects were rarely reported, demonstrating probiotics to be safe. CONCLUSIONS: Despite the encouraging results - reducing new episodes of respiratory infections - the authors emphasize the need for further research, especially in developing countries, where rates of respiratory infections in children are higher when compared to the high per capita-income countries identified in this review.
