Probiotics for preventing acute upper respiratory tract infections

Qiukui Hao; Zhenchan Lu; Bi Rong Dong; Chang Quan Huang; Taixiang Wu

doi:10.1002/14651858.CD006895.pub2

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Figure 1

Chinese Biomedical Literature Database search strategy.

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Figure 2

'Risk of bias' graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

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Figure 3

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

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Analysis 1.1

Comparison 1 ITT analysis: Probiotics versus placebo: primary outcome measures, Outcome 1 Number of participants who experienced URTI episodes.

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Analysis 1.2

Comparison 1 ITT analysis: Probiotics versus placebo: primary outcome measures, Outcome 2 The mean duration of an episode of URTI.

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Analysis 1.3

Comparison 1 ITT analysis: Probiotics versus placebo: primary outcome measures, Outcome 3 The episode rate of URTIs (events per person/year).

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Analysis 2.1

Comparison 2 ITT analysis: Probiotics versus placebo: prescribe antibiotics for acute URTIs, Outcome 1 The number of participants who used antibiotics.

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Analysis 3.1

Comparison 3 ITT analysis: Probiotics versus placebo: adverse events, Outcome 1 Probiotics versus placebo: adverse events.

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Analysis 4.1

Comparison 4 PP analysis: Probiotics versus placebo: primary outcome measures, Outcome 1 Number of participants who experienced URTI episodes.

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Analysis 4.2

Comparison 4 PP analysis: Probiotics versus placebo: primary outcome measures, Outcome 2 The mean duration of an episode of URTI.

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Analysis 4.3

Comparison 4 PP analysis: Probiotics versus placebo: primary outcome measures, Outcome 3 The episode rate of URTI (events per person/year).

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Analysis 5.1

Comparison 5 PP analysis: Probiotics versus placebo: prescribe antibiotics for acute URTIs, Outcome 1 The number of participants who used antibiotics.

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Analysis 6.1

Comparison 6 PP analysis: Probiotics versus placebo: adverse events, Outcome 1 Probiotics versus placebo: adverse events.

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Comparison 1. ITT analysis: Probiotics versus placebo: primary outcome measures

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number of participants who experienced URTI episodes Show forest plot	6		Odds Ratio (IV, Random, 95% CI)	Subtotals only

1.1 Number of participants who experienced URTI episodes: at least 1 event	6	1836	Odds Ratio (IV, Random, 95% CI)	0.58 [0.36, 0.92]
1.2 Number of participants who experienced URTI episodes: at least 3 events	3	650	Odds Ratio (IV, Random, 95% CI)	0.53 [0.36, 0.80]
2 The mean duration of an episode of URTI Show forest plot	2	620	Mean Difference (IV, Random, 95% CI)	‐0.29 [‐3.71, 3.13]

2.1 Marathon runners	1	141	Mean Difference (IV, Random, 95% CI)	1.60 [‐0.34, 3.54]
2.2 General healthy population	1	479	Mean Difference (IV, Random, 95% CI)	‐1.90 [‐2.04, ‐1.76]
3 The episode rate of URTIs (events per person/year) Show forest plot	4	1454	Rate Ratio (Random, 95% CI)	0.88 [0.81, 0.96]

Comparison 1. ITT analysis: Probiotics versus placebo: primary outcome measures

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Comparison 2. ITT analysis: Probiotics versus placebo: prescribe antibiotics for acute URTIs

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 The number of participants who used antibiotics Show forest plot	3	1104	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.45, 0.98]

Comparison 2. ITT analysis: Probiotics versus placebo: prescribe antibiotics for acute URTIs

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Comparison 3. ITT analysis: Probiotics versus placebo: adverse events

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Probiotics versus placebo: adverse events Show forest plot	2	956	Odds Ratio (IV, Random, 95% CI)	0.92 [0.37, 2.28]

Comparison 3. ITT analysis: Probiotics versus placebo: adverse events

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Comparison 4. PP analysis: Probiotics versus placebo: primary outcome measures

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number of participants who experienced URTI episodes Show forest plot	6		Odds Ratio (IV, Random, 95% CI)	Subtotals only

1.1 Number of participants who experienced URTI episodes: at least 1 event	6	1669	Odds Ratio (IV, Random, 95% CI)	0.54 [0.32, 0.90]
1.2 Number of participants who experienced URTI episodes: at least 3 events	3	582	Odds Ratio (IV, Random, 95% CI)	0.56 [0.37, 0.84]
2 The mean duration of an episode of URTI Show forest plot	2	573	Mean Difference (IV, Random, 95% CI)	‐0.31 [‐3.73, 3.10]

2.1 Marathon runners	1	119	Mean Difference (IV, Random, 95% CI)	1.60 [‐0.50, 3.70]
2.2 General healthy population	1	454	Mean Difference (IV, Random, 95% CI)	‐1.90 [‐2.05, ‐1.75]
3 The episode rate of URTI (events per person/year) Show forest plot	4		Rate Ratio (Random, 95% CI)	0.89 [0.83, 0.94]

Comparison 4. PP analysis: Probiotics versus placebo: primary outcome measures

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Comparison 5. PP analysis: Probiotics versus placebo: prescribe antibiotics for acute URTIs

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 The number of participants who used antibiotics Show forest plot	3	1046	Risk Ratio (M‐H, Random, 95% CI)	0.67 [0.46, 0.98]

Comparison 5. PP analysis: Probiotics versus placebo: prescribe antibiotics for acute URTIs

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Comparison 6. PP analysis: Probiotics versus placebo: adverse events

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Probiotics versus placebo: adverse events Show forest plot	2	839	Odds Ratio (IV, Random, 95% CI)	0.85 [0.34, 2.11]

Comparison 6. PP analysis: Probiotics versus placebo: adverse events

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