Probiotics as adjunctive treatment for chronic rhinosinusitis: a randomized controlled trial

Area of Science:

• Otolaryngology
• Microbiology
• Immunology

Background:

• Chronic inflammatory rhinosinusitis (CIRS) significantly impacts patient quality of life.
• Adjunctive therapies are explored to manage CIRS symptoms.
• The role of oral probiotics in CIRS management requires further investigation.

Purpose of the Study:

• To evaluate the efficacy of oral probiotics, specifically Lactobacillus rhamnosus R0011, as an adjunctive treatment for CIRS.
• To determine if probiotics improve quality of life in CIRS patients compared to placebo.

Main Methods:

• A prospective, randomized, double-blind, placebo-controlled trial was conducted.
• 77 patients with CIRS were randomized to receive either oral Lactobacillus rhamnosus R0011 or placebo for 4 weeks.
• Quality of life was assessed using SNOT-20 scores at 4 and 8 weeks.

Main Results:

• The probiotic group showed a significant improvement in SNOT-20 scores at 4 weeks (P = 0.002), but this was not sustained at 8 weeks (P = 0.37).
• The rhinological domain improved in the probiotic group at 4 weeks but returned to baseline by 8 weeks.
• No significant differences in quality of life, symptom frequency, medication use, or side effects were observed between the probiotic and placebo groups at 4 or 8 weeks.

Conclusions:

• Oral administration of Lactobacillus rhamnosus R0011 did not demonstrate a significant benefit in improving sinonasal quality of life for CIRS patients compared to placebo.
• The transient improvement observed at 4 weeks suggests further research may be needed to understand the long-term effects or optimal use of probiotics in CIRS.
• Current evidence does not support the use of this specific oral probiotic strain for improving quality of life in chronic inflammatory rhinosinusitis.