Comparative probiotic strain efficacy in the prevention of eczema in infants and children: A systematic review and meta-analysis

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. Conclusion: 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.