Probiotics in treatment of respiratory tract infections in children (review of scientific publications)

The incidence of acute respiratory infections (ARI) in children is significantly higher than in adults. The largest number of registered cases occurs in children under 7 years of age. Against the background of the SARS — COV2 pandemic, there is a frequent intercurrent or combined course of ARI. A large taxonomic diversity of ARI pathogens, a high frequency of combined infection, the ability of pathogens to develop resistance to chemotherapy drugs significantly limit the arsenal of therapeutic and preventive options. All this determines the relevance of studying the effectiveness of probiotics as a means of treating and preventing ARI in children. Objective of the study: to evaluate the effectiveness of probiotics in the treatment and prevention of ARI in children based on a critical analysis of literary sources. Methods. An analysis of literary data presented in the scientific systems PubMed, EM BASE, Web of Science and Trip from December 2000 to June 2024 was carried out, dedicated to the clinical use of probiotics for ARI in children. The following keywords and phrases were used as a search query: respiratory infections, microbiota, immunity, cytokines, macrophages, secretory IgA, T-regulatory cells. Results. Clinical studies of recent years confirm that probiotics (mostly Lactocasebacillus GG, L. casei, Bifidobacterium spp.) reduce the frequency, duration and severity of acute respiratory viral infections in children by modulating the immune response (increasing the level of secretory IgA, stimulating the production of IFN-γ and suppressing the synthesis of proinflammatory cytokines). Probiotics have a strain-specific immunomodulatory effect on epithelial cells and cells of the immune system. Preventive use of probiotics reduced the risk of developing ARI by 10–32 %. The use of probiotics in ARIs reduced the duration of the disease by 0.5–1.5 days, decreased the likelihood of an uneven course and the need for antibacterial drugs by 18–25 %. Conclusion. The use of probiotics helps to reduce the frequency and duration of ARI episodes, as well as reduce the frequency of secondary bacterial complications. Their use is considered as one of the key tools for ensuring an effective immune response and increasing the resistance of the macroorganism to respiratory pathogens. To expand the range of probiotic strains used, to clarify their clinical and immunological effects, it is advisable to conduct further scientific research in this area.