Probiotics in the management of atopic dermatitis in infants and children: A meta-analysis

Aims: Atopic dermatitis (AD) or eczema is one of the most common dermatologic problems, especially in infants and children.Probiotic use in the management of atopic dermatitis is widely studied; however, the utility of probiotics for atopic dermatitis remains to be firmly established.This study aims to assess the effect of probiotics on atopic dermatitis in children by conducting a meta-analysis via monitoring the SCORing Atopic Dermatitis (SCORAD) index.Electronic databases of PubMed and Google Scholar were searched from 2012 up to 2021.Methodology and results: Double-blinded randomized clinical trials were included, and subgroup analyses were conducted on probiotic species, treatment duration, participant age and disease severity.Out of 65 reports, only 6 clinical trials (536 infants and children) were included in the quantitative synthesis.The overall pooled change in SCORAD index in infants and children was -3.55 (95%CI, -7.11 to 0.01; p=0.05), indicating that significantly higher SCORAD values favouring probiotics over controls were observed.Lactobacillus pentosus (MD, 0.5; 95%CI, -3.99 to 4.99) showed no significant effect on SCORAD values in infants and children with AD.However, Lactobacillus plantarum and a mixture of probiotic strains showed significant effects on SCORAD values in infants and children with AD.A funnel plot was generated using Stata 16 software for the assessment of publication bias.Conclusion, significance and impact of study: Results from meta-analysis indicated that probiotics are beneficial for the management of atopic dermatitis in infants and children by reducing the SCORAD index, but the species of probiotics that are most efficacious for infants and children with AD have to be carefully assessed given the strainspecific effects of probiotics.