title: Comparative probiotic strain efficacy in the prevention of eczema in infants and children: a systematic review and meta-analysis.
abstract: BACKGROUND
  Eczema affects 3.5% of the global population, with peak prevalence during infancy. Eczema has no cure, but probiotics have been suggested as a preventative measure.
  
  
  OBJECTIVE
  To comprehensively analyze the impact of prenatal and postnatal probiotic supplementation on the prevention of infantile and childhood eczema.
  
  
  METHODS
  MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and PubMed were searched for randomized controlled trials regarding probiotic usage and eczema development from 1945 to 2013. Participants included were 7 years old or younger with probiotic exposure in utero or below 6 months of age and who was not diagnosed previously.
  
  
  RESULTS
  27 publications describing 16 studies assessing 10 probiotics in 2,797 participants met our criterion. The pooled relative risk of all the studies, 0.74 (95% confidence interval 0.67, 0.82), indicated that probiotic supplementation in the first several years of life did have a significant impact on development of eczema. During evaluation of the studies, heterogeneity of terms and definitions for similar primary and secondary outcomes were identified.
  
  
  CONCLUSIONS
  The use of probiotic supplements during pregnancy and/or during infancy creates a statistically significant decline in the incidence of eczema. The heterogeneity of terms and definitions regarding eczema is the major limitation of these studies.
authors.affiliation: F. Edward Hebert School of Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Mansfield
authors.affiliation: F. Edward Hebert School of Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Samuel W
authors.initials: SW
authors.lastname: Bergin
authors.affiliation: F. Edward Hebert School of Medicine, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: James R
authors.initials: JR
authors.lastname: Cooper
authors.affiliation: Department of Preventative Medicine and Biometrics, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Cara H
authors.initials: CH
authors.lastname: Olsen
mesh_terms: D001644:Bifidobacterium; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000175:diagnosis; D019587:Dietary Supplements / Q000382:microbiology*; D004485:Eczema / Q000175:diagnosis / Q000517:prevention & control*; D046128:Fetal Therapies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007778:Lactobacillus; D019936:Probiotics / Q000627:therapeutic use*; D009626:Terminology as Topic