title: Network meta-analysis of probiotics to prevent respiratory infections in children and adolescents.
abstract: Probiotics have emerged as a promising intervention for the prevention of respiratory tract infections (RTIs) in children. Assess the effect of probiotics on prevention of RTIs in children and adolescents. MEDLINE, EMBASE, LILACS, SCIELO, CINAHL, SCOPUS, and Web of Science. Key words: "respiratory tract infections" AND probiotics. Randomized controlled trials RCT assessing the effect of probiotics on RTIs in children and adolescents were included. Two reviewers, working independently, to identify studies that met the eligibility criteria. Main and secondary outcomes were RTIs and adverse effects, respectively. Twenty-one trials with 6.603 participants were included. Pairwise meta-analysis suggested that Lactobacillus casei rhamnosus (LCA) was the only effective probiotic to the rate of RTIs compared to placebo (RR0.38; Crl 0.19-0.45). Network analysis showed that the LCA exhibited 54.7% probability of being classified in first, while the probability of Lactobacillus fermentum CECT5716 (LFC) being last in the ranking was 15.3%. LCA showed no better effect compared to other probiotic strains by indirect analysis. This systematic review found a lack of evidence to support the effect of probiotic on the incidence rate of respiratory infections in children and adolescents. Pediatr Pulmonol. 2017;52:833-843. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Centro Universitário Ritter dos Reis-UniRitter, Rua Orfanotrófio 555, Porto Alegre/RS, Brazil.
authors.forename: Marina Azambuja
authors.initials: MA
authors.lastname: Amaral
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Infant Center, Biomedical Researcho Institute PUCRS, 6681 Ipiranga Av, Partenon, 90619-9000 Porto Alegre City/RS, Brazil.
authors.forename: Gabriela Helena Barbosa Ferreira
authors.initials: GHBF
authors.lastname: Guedes
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Infant Center, Biomedical Researcho Institute PUCRS, 6681 Ipiranga Av, Partenon, 90619-9000 Porto Alegre City/RS, Brazil.
authors.forename: Matias
authors.initials: M
authors.lastname: Epifanio
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Infant Center, Biomedical Researcho Institute PUCRS, 6681 Ipiranga Av, Partenon, 90619-9000 Porto Alegre City/RS, Brazil.
authors.forename: Mario Bernardes
authors.initials: MB
authors.lastname: Wagner
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Infant Center, Biomedical Researcho Institute PUCRS, 6681 Ipiranga Av, Partenon, 90619-9000 Porto Alegre City/RS, Brazil.
authors.forename: Marcus Herbert
authors.initials: MH
authors.lastname: Jones
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Infant Center, Biomedical Researcho Institute PUCRS, 6681 Ipiranga Av, Partenon, 90619-9000 Porto Alegre City/RS, Brazil.
authors.forename: Rita
authors.initials: R
authors.lastname: Mattiello
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000517:prevention & control*
keywords: probiotics; respiratory tract infections