Effects of probiotics for the treatment of atopic dermatitis: a meta-analysis of randomized controlled trials

Background: The effects of probiotics on the treatment of atopic dermatitis (AD) are inconclusive. Objective: To determine the clinical effect of probiotics in the management of AD overall and in different age groups. Methods: A comprehensive search of databases through December 2013 was performed. For this meta-analysis, randomized controlled trials measuring the treatment effects of probiotics or synbiotics in patients diagnosed with AD were included. The primary outcome was a difference in Scoring of Atopic Dermatitis (SCORAD) values between the treatment and placebo groups overall and in different age populations. Results: Twenty-five randomized controlled trials (n = 1,599) were available for this meta-analysis. Significant differences in SCORAD values favoring probiotics over the control were observed overall (mean -4.51, 95% confidence interval -6.78 to -2.24), in children 1 to 18 years old (-5.74, 95% confidence interval -7.27 to -4.20), and in adults (-8.26, 95% confidence interval -13.28 to -3.25). However, the effectiveness of probiotics in infants (<1 year old) with AD was not proved. The effect of synbiotic use was not significantly different from that of probiotic use. Treatment with a mixture of different bacterial species or of Lactobacillus species showed greater benefit than did treatment with Bifidobacterium species alone. Conclusion: The overall result of this meta-analysis suggests that probiotics could be an option for the treatment of AD, especially for moderate to severe AD in children and adults. However, no evidence was found supporting the beneficial role of probiotics in infants. (C) 2014 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.