The efficacy of Lactobacillus reuteri in infants and children

Background:

The aim of this review was to systematically review and update evidence on the efficacy and safety of using L. reuteri DSM 17938, regardless of the indication, in infants and children. The choice of the probiotic strain was determined by the facts that it is widely available and it is commonly used in the pediatric population.

Method:

We aimed to systematically evaluate evidence on the effectiveness of Lactobacillus reuteri DSM 17938 (L. reuteri) for treating and preventing diseases in infants and children. MEDLINE and the Cochrane Library were searched in December 2013, with no language restrictions, for relevant randomized controlled trials (RCTs) and meta-analyses. The search was updated in April 2014. One systematic review and 14 RCTs met the inclusion criteria.

Results:

The use of L. reuteri may be considered in the management of acute gastroenteritis as an adjunct to rehydration. There is some evidence that L. reuteri is effective in reducing the incidence of diarrhea in children attending day care centers. There is no evidence of effectiveness of L. reuteri in preventing nosocomial diarrhea in children. The administration of L. reuteri is likely to reduce crying time in infants with infantile colic in exclusively or predominantly exclusively breast-fed infants, but not in formula-fed infants. More studies are needed. Preliminary data suggest that L. reuteri may be effective in the prevention of some functional gastrointestinal disorders, such as colic and regurgitation. This innovative approach needs further evaluation by an independent research team. Preliminary evidence provides a rationale for further assessing the efficacy of L. reuteri for treating functional constipation or functional abdominal pain. However, it is too soon to recommend the routine use of L. reuteri for these conditions. There are no safety concerns with regard to the use of L. reuteri in nonimmunocompromised subjects. There are also data to support the safety of using L. reuteri in preterm infants.

Conclusion:

Our results precisely define current evidence on the effects of the administration of L. reuteri DSM 17938 to the pediatric population.