Scolaris Content Display Scolaris Content Display

Probiotici za liječenje ekcema

Esta versión no es la más reciente

Abstract

disponible en

Background

Probiotics have been proposed as an effective treatment for eczema, and recently a number of clinical trials have been undertaken.

Objectives

To assess the effects of probiotics for the treatment of eczema

Search methods

We searched the Cochrane Skin Group Specialised Register (to April 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2,2008) MEDLINE (from 2003 to April 2008), EMBASE (from 2005 to April 2008), PsycINFO, AMED and LILACS (from inception to April 2008) and ISI Web of Science (to December 2006) and reference lists of articles. We also searched registries of ongoing clinical trials, conference proceedings and searched for adverse events.

Selection criteria

Randomised controlled trials of live orally ingested microorganisms for the treatment of eczema.

Data collection and analysis

Two authors independently applied eligibility criteria, assessed the quality of trials and extracted data. We contacted study authors for more information where necessary. We recorded adverse events from the included studies, and from the separate adverse events search.

Main results

Twelve randomised controlled trials involving 781 participants met the inclusion criteria. All trial participants were children. There was no significant difference in participant or parent‐rated symptom scores in favour of probiotic treatment (5 trials, 313 participants). Symptom severity on a scale from 0 to20 was 0.90 points lower after probiotic treatment than after placebo (95%CI ‐1.04, 2.84; p = 0.36).There was also no significant difference in participant or parent‐rated overall eczema severity in favour of probiotic treatment (3 trials, 150 participants). There was no significant difference in investigator rated eczema severity between probiotic and placebo treatments (7 trials, 588 participants). On a scale from 0 to 102 investigator rated eczema severity was 2.46 points lower after probiotic treatment than after placebo treatment (95%CI ‐2.53, 7.45 p = 0.33). Significant heterogeneity was noted between the results of individual studies, which may be explained by the use of different probiotic strains. Subgroup analysis by age of participant, severity of eczema, presence of atopy or presence of food allergy did not identify a population with different treatment outcomes to the population as a whole. The adverse events search identified some case reports of infections and bowel ischaemia caused by probiotics.

Authors' conclusions

The evidence suggests that probiotics are not an effective treatment for eczema, and probiotic treatment carries a small risk of adverse events.

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Plain language summary

Probiotici za liječenje ekcema

Nema dovoljno dokaza da bi se moglo preporučiti korištenje probiotika za liječenje ekcema.

Ekcem je bolest kože obilježena svrbežom i crvenim osipom koja pogađa između 5 i 20% ljudi širom svijeta u neko doba života. Osobe s ekcemom imaju drugačije bakterije u crijevima u odnosu na osobe bez ekcema te se ponekad kod njih bilježi upala u crijevima. Stoga se postavlja pitanje je li možda moguće liječiti simptome ekcema mijenjanjem sastava bakterija u crijevima ili smanjenjem upale crijeva. Jedna vrsta terapije koja bi to mogla postići su probiotici ‐ to su živi mikroorganizmi koji se uzimaju na usta, kao što su Lactobacillus bakterije koje se nalaze u nepasteriziranom mlijeku i jogurtu. Ovaj Cochrane sustavni pregled pronašao je da probiotici ne smanjuju simptome ekcema kao što su svrbež niti smanjuju ukupnu težinu ekcema, prema procjeni pacijenata i njihovih liječnika. Rezultati su se razlikovali u pojedinim studijama, ali ukupno ne pokazuju da su probiotici učinkovita terapija za ekcem. Potrebne su daljnje studija o probioticima za ekcem jer je moguće da nisu istražene sve dostupne vrste probiotika i da bi možda neke druge vrste bile djelotvornije. Probiotici u rijetkim slučajevima mogu uzrokovati upale i probleme sa crijevima.