Probiotics Cut Fever Duration in Children With URTIs

TOPLINE:

A probiotic mixture containing three specific strains reduced fever duration by 2 days in children with upper respiratory tract infections (URTIs). The treatment showed significant efficacy with a median fever duration of 3 days vs 5 days for placebo.

METHODOLOGY:

• A randomized clinical trial was conducted between November 2021 and June 2023 at the pediatric emergency department (ED) of Ca’ Granda Ospedale Maggiore Policlinico.
• Researchers enrolled 128 patients aged 28 days to 4 years with fever (≥ 38.5 °C) and URTIs, with 69 men (54%) and a mean age of 2.5 years.
• The probiotic group received daily 0.5-mL doses containing Bifidobacterium breve M-16V, Bifidobacterium lactis HNO19, and Lactobacillus rhamnosus HNOO1 for 14 days, while the placebo group received a matching volume of placebo.
• The primary outcome measure was fever duration, defined as the days between the first and last fever occurrence.

TAKEAWAY:

• In this trial of 128 children with URTIs, the probiotic mixture significantly shortened fever duration compared with placebo (median, 3 days vs 5 days; adjusted risk ratio, 0.64; 95% CI, 0.51-0.80).
• Few mild adverse events were reported in the probiotic and placebo groups, respectively, including constipation (16% vs 12%; P = .80) and abdominal pain (8% vs 4%; P = .65).
• The findings suggest probiotics’ potential as an effective adjuvant therapy for reducing fever duration in pediatric URTIs.

IN PRACTICE:

“The administration of these supplements did not reduce the incidence of diarrhea in children receiving antibiotics or the prescription of antibiotics after ED discharge. Overall, the probiotic mixture was safe, and few mild adverse events were observed,” wrote the authors of the study.

SOURCE:

The study was led by Carlo Agostoni, MD, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico in Milan, Italy. It was published online on March 14 in JAMA Network Open.

LIMITATIONS:

The researchers did not differentiate between bacterial and viral infections or investigate specific infectious diseases. The diagnosis of URTIs and antibiotic prescriptions relied on individual physician evaluation without standardization. Participants received supplementation at different stages of disease progression due to the ED setting. Temperature measurements were conducted at home without direct research staff supervision, though caregivers received specific instructions and monitoring through telephone follow-up. The single-center design and sample size calculation based solely on the primary outcome may have limited the detection of other effects.

DISCLOSURES:

The study received funding from the Italian Ministry of Health and an unrestricted grant to the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico from Coree Srl. The funders had no role in the study’s design, conduct, data analysis, manuscript preparation, or publication decision.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.