title: Probiotics in the prevention of eczema: a randomised controlled trial.
abstract: OBJECTIVE
  To evaluate a multistrain, high-dose probiotic in the prevention of eczema.
  
  
  METHODS
  A randomised, double-blind, placebo-controlled, parallel group trial.
  
  
  METHODS
  Antenatal clinics, research clinic, children at home.
  
  
  METHODS
  Pregnant women and their infants.
  
  
  METHODS
  Women from 36 weeks gestation and their infants to age 6 months received daily either the probiotic (Lactobacillus salivarius CUL61, Lactobacillus paracasei CUL08, Bifidobacterium animalis subspecies lactis CUL34 and Bifidobacterium bifidum CUL20; total of 10(10) organisms/day) or matching placebo.
  
  
  METHODS
  Diagnosed eczema at age 2 years. Infants were followed up by questionnaire. Clinical examination and skin prick tests to common allergens were done at 6 months and 2 years.
  
  
  RESULTS
  The cumulative frequency of diagnosed eczema at 2 years was similar in the probiotic (73/214, 34.1%) and placebo arms (72/222, 32.4%; OR 1.07, 95% CI 0.72 to 1.6). Among the secondary outcomes, the cumulative frequency of skin prick sensitivity at 2 years was reduced in the probiotic (18/171; 10.5%) compared with the placebo arm (32/173; 18.5%; OR 0.52, 95% CI 0.28 to 0.98). The statistically significant differences between the arms were mainly in sensitisation to cow's milk and hen's egg proteins at 6 months. Atopic eczema occurred in 9/171 (5.3%) children in the probiotic arm and 21/173 (12.1%) in the placebo arm (OR 0.40, 95% CI 0.18 to 0.91).
  
  
  CONCLUSIONS
  The study did not provide evidence that the probiotic either prevented eczema during the study or reduced its severity. However, the probiotic seemed to prevent atopic sensitisation to common food allergens and so reduce the incidence of atopic eczema in early childhood.
  
  
  BACKGROUND
  ISRCTN26287422.
authors.affiliation: College of Medicine, Swansea University, Swansea, UK.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Allen
authors.affiliation: College of Human and Health Sciences, Swansea University, Swansea, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Jordan
authors.affiliation: College of Medicine, Swansea University, Swansea, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Storey
authors.affiliation: College of Medicine, Swansea University, Swansea, UK.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Thornton
authors.affiliation: College of Medicine, Swansea University, Swansea, UK.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Gravenor
authors.affiliation: Research and Development Department, Cultech Limited, Port Talbot, UK.
authors.forename: Iveta
authors.initials: I
authors.lastname: Garaiova
authors.affiliation: Research and Development Department, Cultech Limited, Port Talbot, UK.
authors.forename: Susan F
authors.initials: SF
authors.lastname: Plummer
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK.
authors.forename: Duolao
authors.initials: D
authors.lastname: Wang
authors.affiliation: College of Medicine, Swansea University, Swansea, UK.
authors.forename: Gareth
authors.initials: G
authors.lastname: Morgan
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004485:Eczema / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D019936:Probiotics / Q000627:therapeutic use*; D012882:Skin Tests; D011795:Surveys and Questionnaires
keywords: Allergy; Dermatology; Microbiology