Comparative efficacy of different probiotic strains and preparations for prevention of acute otitis media in children: a systematic review and network meta-analysis
Ye M, Xu X, Huang W, Du X, Liu Y, Yang G
Published in Front Nutr, Vol. 13, pp. 1847652
Methodology
Systematic review and frequentist network meta-analysis of RCTs of probiotics for preventing AOM in children aged 0 to 18, searched to March 2026. Eighteen RCTs (20 publications, 4,462 children) compared seven probiotic groups (S. salivarius K12, S. salivarius 24SMB, BB-12, CBA-L74, LGG, multi-strain and alpha-streptococci) with placebo.
Key Findings
Only CBA-L74 (OR 0.27, 95% CI 0.11 to 0.68) and S. salivarius K12 (OR 0.44, 95% CI 0.20 to 0.94) significantly reduced AOM versus placebo. Excluding two high risk-of-bias trials, the K12 effect was substantially attenuated and lost significance, while CBA-L74 held (OR 0.28, 95% CI 0.14 to 0.56). Multi-strain products and LGG reduced antibiotic prescribing. No product reduced tympanostomy tube placement.
Conclusions
The authors conclude that probiotic efficacy for AOM prevention is highly strain-specific.
Limitations
Network meta-analyses of small trials per strain are fragile: the K12 result depended on high-risk-of-bias trials, and the abstract does not say how many trials contributed to each strain.
Supplements Studied
Probiotic efficacy for AOM prevention is highly strain-specific
Related Health Concerns
Study Details
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