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Effect of Probiotics on Urinary Tract Infections in Children: A Systematic Review and Meta-Analysis
Elham Emami1, Catherine Mt Sherwin2, Saeid Heidari-Soureshjani3
1Emam Hossein Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Probiotics may offer an alternative preventive therapy for children at risk of urinary tract infections (UTIs). While showing a slight protective effect, further large-scale trials are needed to confirm their efficacy in preventing UTIs.
Area of Science:
- Pediatrics
- Microbiology
- Preventive Medicine
Background:
- Urinary tract infections (UTIs) represent the most common bacterial infections in children globally.
- Understanding preventive strategies is crucial for managing pediatric UTIs.
Purpose of the Study:
- To evaluate the effectiveness of probiotics in preventing UTIs in pediatric patients.
- To synthesize existing evidence on probiotic use for UTI prevention in children.
Main Methods:
- A systematic review and meta-analysis of studies from Web of Science, PubMed, and Scopus.
- Quality assessment using the Jadad scale and heterogeneity analysis with Cochran Q and I2.
- Pooled odds ratio (OR) calculated using a random-effects model; publication bias assessed via Egger's and Begg's tests.
Main Results:
- Eleven studies were included in the meta-analysis.
- Probiotic use was associated with a reduced odds of developing or recurring UTIs (OR=0.94, 95% CI: 0.88-0.999, p=0.046).
- No significant publication bias was detected.
Conclusions:
- Probiotics present a potential non-pharmaceutical alternative for UTI prophylaxis in children.
- Current evidence suggests a possible protective role, but it is not definitively confirmed.
- Large-scale randomized clinical trials are recommended to establish the prophylactic efficacy of probiotics against UTIs.
Background:
Urinary tract infections (UTIs) are the most prevalent bacterial infections that occur in children worldwide.
Objective:
This meta-analysis aims to investigate the utility of probiotics as preventive therapy in children with a UTI.
Methods:
The Web of Science, PubMed, and Scopus were searched for articles that investigated the relationship between probiotic consumption and the risk of UTIs. The quality of the articles was evaluated using the Jadad scale. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effects model. Subgroup analyses and sensitivity analyses were also conducted. The Cochran Q test and the statistic I2 were used to evaluate heterogeneity. To determine any potential publication bias, the Egger's and Begg's tests were used.
Results:
In total, eleven studies were selected for the systematic review and meta-analysis. Compared to children who did not receive probiotics, the OR of developing or having a recurring urinary tract infection in those who received probiotics was 0.94 (95% CI; 0.88-0.999; p-value=0.046). The Begg's and Egger's tests showed no evidence of publication bias between probiotics and the risk of developing new or recurring urinary tract infections.
Conclusion:
Based on this systematic review and meta-analysis, probiotics could be an alternative therapy for children who are at risk of developing a UTI. They are non-pharmaceutical options and could be used as natural prophylaxis for UTIs. However, the currently published evidence does not irrefutably confirm that probiotics provide a protective effect against urinary bacterial infections. Therefore, there need to be large-scale randomized clinical trials undertaken to investigate the possible prophylaxis of probiotics.
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