Probiotic use for treating child eczema questioned

THE use of probiotics to treat eczema in children has been questioned by a Cochrane review that found the products failed to relieve eczema symptoms and may cause adverse events.

The review of 12 randomised controlled trials involving 781 children diagnosed with eczema also found that children who consumed Lactobacillus rhamnosus or other Lactobacillus strains showed no reduction in eczema symptoms, such as itching, or any improvement in eczema severity compared to children who received placebo or no treatment.

“The data suggest that probiotics are not an effective treatment for eczema symptoms and are not effective at overall control of eczema,” the review authors wrote. Consumption of probiotics also raised safety concerns, with 46 patients suffering bacterial or fungal sepsis and some cases of ischaemic bowel.

The review’s findings fail to lend weight to the hypothesis that the consumption of live organisms may benefit patients with eczema, after evidence showed their intestinal microflora differed from those free of the condition.

“Further studies of new probiotics are needed, because it is possible that different types of probiotics which haven’t yet been studied in eczema treatment could be more effective,” the review said.

Associate Professor John Ziegler, head of the department of immunology and infectious diseases at Sydney Children’s Hospital, said recommendations to administer probiotics should be limited to species of organisms on which sound evidence is available. 

“The risks associated with the administration of living organisms must be taken into account,” he said.

Professor Ziegler said parents tended to under-use topical steroids and that children benefited significantly when GPs provided reassurance that when advice is followed topical steroids are safe.

Cochrane Database Syst Rev 2008; Issue 4.