Allergy Care - Probiotics

Everyone is now familiar with probiotics. The so-called friendly bacteria are on our supermarket shelves and heavily promoted on our television screens. The growth of probiotics has even spread into eczema.

Over the last few years there has been increasing interest in the role of probiotic supplements in the prevention and treatment of atopic eczema in children. Needless to say, the probiotic marketing machine has not been slow to catch on to this and probiotics have begun to gain in popularity as an alternative treatment for childhood eczema. But are they effective?

The Cochrane Centre was set up by the NHS Research and Development programme in 1992. One of its functions is to assess evidence for and against the effectiveness of treatments in specific circumstances. It does this by co-opting an independent group of experts who are set the task of reviewing all the published data on the subject, and making a totally objective recommendation.

Recently the Cochrane Centre has reviewed the role of probiotics in the management of atopic eczema in children. They analysed 12 studies performed between 2003 and 2008 involving 781 children, all comparing the probiotic supplement to placebo. A number of different types of probiotic were used and the most common was a Lactobacillus. The studies measured short-term changes in symptoms and quality of life.

Confusingly, the studies did not give any uniform result. Some were encouraging, others disappointing. The reason for this is unknown despite attempts at subanalysis to see if, for instance, the precise species of probiotic was significant.

The Cochrane review was published in the Oct. 8, 2008 issue of the Cochrane Library and concluded that “the data suggest that probiotics are not an effective treatment for eczema symptoms and are not effective at overall control of eczema.” The authors added the caveat that although “a significant benefit cannot be confidently excluded ... analysis of composite severity score data suggests that any reduction in eczema severity from probiotic treatment is likely to be modest and therefore unlikely to be clinically significant.”

The official objective view, therefore, is that there is not enough evidence to say that probiotic supplements help the prevention or treatment of atopic eczema. As always, there will be individual cases which refute this conclusion and the experts do make the point that probiotics are generally safe.