Can Oral Probiotics Help Prevent Childhood Ear Infections?

A recent clinical trial published in Journal of American Medical Association examined the effectiveness of Streptococcus salivarius K12 oral probiotics to prevent acute otitis media (AOM), a prevalent reason for antibiotic use in children. 

Carried forward in Finland from August 2020 to May 2021 across 50 daycare centers, the double-blind, randomized, placebo-controlled trial involved 827 children aged 1 to 6 years. Excluding those under antimicrobial prophylaxis or with immunodeficiency, participants were given a daily dose of either S. salivarius K12 or a placebo for six months.

The primary outcome measured the proportion of children experiencing at least one episode of AOM requiring antimicrobial therapy within the study period. Surprisingly, the results revealed that the daily use of S. salivarius K12 products did not significantly reduce the occurrence of AOM.

Out of the 827 children, 34 (8.2%) in the S. salivarius group and 24 (5.8%) in the placebo group encountered AOM, indicating a relative risk of 1.42. The proportion difference was -2.44% (95% CI, -5.94% to 1.09%), with a p-value of 0.17, suggesting no statistically significant difference between the groups.

The time to the first AOM episode also showed no significant distinction, with 174 days in the S. salivarius group compared to 176 days in the placebo group.

These findings challenge the potential of S. salivarius K12 oral probiotics as a preventive measure against AOM in children. While the results indicate no harm in usage, the study underscores the need for continued exploration of alternative approaches to primary prevention of AOM.

As the medical community strives to reduce the burden of antibiotic use in children, this study contributes valuable insights, emphasizing the ongoing necessity for innovative strategies in the prevention of common childhood infections.

Source: 

Sarlin, S., Koskela, U., Honkila, M., Tähtinen, P. A., Pokka, T., Renko, M., & Tapiainen, T. (2023). Streptococcus salivarius Probiotics to Prevent Acute Otitis Media in Children. In JAMA Network Open (Vol. 6, Issue 11, p. e2340608). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.40608