Skip to main content
SpringerLink
Log in

The Role of Probiotics in the Prevention and Treatment of Atopic Dermatitis in Children: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Systematic Review
  • Published:
Pediatric Drugs Aims and scope Submit manuscript

Abstract

Background

Atopic dermatitis (AD) is a chronic inflammatory skin disease common among infants and children. It is associated with a high risk of allergies, asthma, and mental health problems. Attempts have been made to use probiotics in clinical interventions for AD.

Objective

Our objective was to perform an updated meta-analysis of recently published studies to evaluate the effect of probiotics in the prevention and treatment of AD in children and to further understand the role of probiotics in AD interventions in the clinic.

Method

We searched the PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Wanfang databases with prespecified selection criteria from inception of each database to 11 January 2020. No language restrictions were applied.

Results

A total of 25 studies were included in our meta-analysis. Of these, 14 were prevention studies (with 3049 children enrolled) and 11 were treatment studies (with 816 children enrolled). One treatment study was excluded after the sensitivity analysis. From the 14 prevention studies included, the pooled relative risk ratio of AD in those treated with probiotics versus placebo was 0.70 [95% confidence interval (CI) 0.57–0.84; P = 0.0002]. Subgroup analyses showed that only mixed strains of probiotics had a significant effect on lowering the incidence of AD. Probiotics administered solely to infants did not prevent the development of AD, but effects were significant when probiotics were administered to both pregnant mothers and their infants or solely to pregnant mothers. In studies with treatment durations > 6 months, the incidence of AD decreased significantly; a similar effect was achieved when the treatment duration was < 6 months. Meta-analysis of the ten treatment studies showed a significant decrease in the weighted mean difference (WMD) in Scoring Atopic Dermatitis (SCORAD) index values in the probiotics group compared with the control group (WMD, − 7.23; 95% CI − 10.59 to − 3.88; P < 0.0001). Subgroup analyses showed that both single-strain and mixed-strain probiotics had a significant effect on improving SCORAD values. Studies with participants aged < 1 year (P = 0.07) reported no significant results. In studies with treatment periods > 8 weeks, SCORAD values seemed to decrease more than in studies with treatment periods < 8 weeks. However, the subgroup difference was only statistically significant when the analysis was performed according to participant age in prevention studies.

Conclusion

Our updated meta-analysis demonstrates that interventions with probiotics potentially lower the incidence of AD and relieve AD symptoms in children, particularly when treating infants and children aged ≥ 1 year with AD. Interventions with mixed-strain probiotics tended to have better preventive and curative effects. Probiotics administered solely to infants appeared to produce negative preventive effects. Different intervention durations might also affect clinical outcomes. However, given the insignificant subgroup differences, except for treatment by participant age, and the moderate heterogeneity among the studies, these conclusions should be interpreted with caution, and more powerful randomized controlled trials using standardized measurements should be conducted to assess the long-term effects of probiotics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sung M, Lee KS, Ha EG, Lee SJ, Kim MA, Lee SW, et al. An association of periostin levels with the severity and chronicity of atopic dermatitis in children. Pediatr Allerg Immunol. 2017;28(6):543–50.

    Google Scholar 

  2. Boguniewicz M, Schmid-Grendelmeier P, Leung DY. Atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):40–3.

    CAS  PubMed  Google Scholar 

  3. Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109–22.

    PubMed  Google Scholar 

  4. Eichenfield LF, Ahluwalia J, Waldman A, Borok J, Udkoff J, Boguniewicz M. Current guidelines for the evaluation and management of atopic dermatitis: a comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines. J Allergy Clin Immunol. 2017;139(4S):S49–57.

    PubMed  Google Scholar 

  5. Eichenfield LF, Tom WL, Berger TG, Krol A, Paller AS, Schwarzenberger K, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am ACad Dermatol. 2014;71(1):116–32.

    PubMed  PubMed Central  Google Scholar 

  6. Lewis MC, Inman CF, Patel D, Schmidt B, Mulder I, Miller B, et al. Direct experimental evidence that early-life farm environment influences regulation of immune responses. Pediatr Allergy Immunol. 2012;23(3):265–9.

    PubMed  Google Scholar 

  7. Okada H, Kuhn C, Feillet H, Bach JF. The 'hygiene hypothesis' for autoimmune and allergic diseases: an update. Clin Exp Immunol. 2010;160(1):1–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Zheng H, Liang H, Wang Y, Miao M, Shi T, Yang F, et al. Altered gut microbiota composition associated with eczema in infants. PLoS ONE. 2016;11(11):e166026.

    Google Scholar 

  9. Hong P, Lee BW, Aw M, Shek LPC, Yap GC, Chua KY, et al. Comparative analysis of fecal microbiota in infants with and without eczema. PLoS ONE. 2010;5(4):e9964.

    PubMed  PubMed Central  Google Scholar 

  10. Guarner F, Schaafsma GJ. Probiotics. Int J Food Microbiol. 1998;39(3):237–8.

    CAS  PubMed  Google Scholar 

  11. Vongbhavit K, Underwood MA. Prevention of necrotizing enterocolitis through manipulation of the intestinal microbiota of the premature infant. Clin Ther. 2016;38(4):716–32.

    PubMed  PubMed Central  Google Scholar 

  12. Binns C, Lee MK. The use of probiotics to prevent diarrhea in young children attending child care centers: a review. J Exp Clin Med. 2010;2(6):269–73.

    Google Scholar 

  13. Wickens K, Barthow C, Mitchell EA, Stanley TV, Purdie G, Rowden J, et al. Maternal supplementation alone with Lactobacillus rhamnosus HN001 during pregnancy and breastfeeding does not reduce infant eczema. Pediatr Allergy Immunol. 2018;29(3):296–302.

    PubMed  Google Scholar 

  14. Dotterud CK, Storro O, Johnsen R, Oien T. Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial. Br J Dermatol. 2010;163(3):616–23.

    CAS  PubMed  Google Scholar 

  15. Navarro-Lopez V, Ramirez-Bosca A, Ramon-Vidal D, Ruzafa-Costas B, Genoves-Martinez S, Chenoll-Cuadros E, et al. Effect of oral administration of a mixture of probiotic strains on SCORAD index and use of topical steroids in young patients with moderate atopic dermatitis a randomized clinical trial. JAMA Dermatol. 2018;154(1):37–433.

    PubMed  Google Scholar 

  16. Folster-Holst R, Muller F, Schnopp N, Abeck D, Kreiselmaier I, Lenz T, et al. Prospective, randomized controlled trial on Lactobacillus rhamnosus in infants with moderate to severe atopic dermatitis. Br J Dermatol. 2006;155(6):1256–61.

    CAS  PubMed  Google Scholar 

  17. Lee J, Seto D, Bielory L. Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis. J Allergy Clin Immunol. 2008;121(1):116–21.

    PubMed  Google Scholar 

  18. Zuccotti G, Meneghin F, Aceti A, Barone G, Callegari ML, Di Mauro A, et al. Probiotics for prevention of atopic diseases in infants: systematic review and meta-analysis. Allergy. 2015;70(11):1356–71.

    CAS  PubMed  Google Scholar 

  19. Panduru M, Panduru NM, Salavastru CM, Tiplica GS. Probiotics and primary prevention of atopic dermatitis: a meta-analysis of randomized controlled studies. J Eur Acad Dermatol Venereol. 2015;29(2):232–42.

    CAS  PubMed  Google Scholar 

  20. Pelucchi C, Chatenoud L, Turati F, Galeone C, Moja L, Bach JF, et al. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology. 2012;23(3):402–14.

    PubMed  Google Scholar 

  21. Michail SK, Stolfi A, Johnson T, Onady GM. Efficacy of probiotics in the treatment of pediatric atopic dermatitis: a meta-analysis of randomized controlled trials. Ann Allergy Asthma Immunol. 2008;101(5):508–16.

    PubMed  Google Scholar 

  22. Huang R, Ning H, Shen M, Li J, Zhang J, Chen X. Probiotics for the treatment of atopic dermatitis in children: a systematic review and meta-analysis of randomized controlled trials. Front Cell Infect Microbiol. 2017;7:392.

    PubMed  PubMed Central  Google Scholar 

  23. Doege K, Grajecki D, Zyriax BC, Detinkina E, Zu EC, Buhling KJ. Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood—a meta-analysis. Br J Nutr. 2012;107(1):1–6.

    CAS  PubMed  Google Scholar 

  24. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.

    PubMed  PubMed Central  Google Scholar 

  25. Atherton J, Bieber T, Bonilazi E, Broberg A, Calza A, et al. Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European Task Force on Atopic Dermatitis. Dermatology. 1993;186(1):23–31.

    Google Scholar 

  26. Copas J, Shi JQ. Meta-analysis, funnel plots and sensitivity analysis. Biostatistics. 2000;1(3):247–62.

    CAS  PubMed  Google Scholar 

  27. Wickens K, Black PN, Stanley TV, Mitchell E, Fitzharris P, Tannock GW, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol. 2008;122(4):788–94.

    PubMed  Google Scholar 

  28. Kim JY, Kwon JH, Ahn SH, Lee SI, Han YS, Choi YO, et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatr Allergy Immunol. 2010;21(2 Pt 2):e386–e393393.

    PubMed  Google Scholar 

  29. Rautava S, Kainonen E, Salminen S, Isolauri E. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol. 2012;130(6):1355–60.

    CAS  PubMed  Google Scholar 

  30. Plummer EL, Chebar LA, Tobin JM, Uebergang JB, Axelrad C, Garland SM, et al. Postnatal probiotics and allergic disease in very preterm infants: sub-study to the ProPrems randomized trial. Allergy. 2020;75(1):127–36.

    CAS  PubMed  Google Scholar 

  31. Ou CY, Kuo HC, Wang L, Hsu TY, Chuang H, Liu CA, et al. Prenatal and postnatal probiotics reduces maternal but not childhood allergic diseases: a randomized, double-blind, placebo-controlled trial. Clin Exp Allergy. 2012;42(9):1386–96.

    PubMed  Google Scholar 

  32. Taylor AL, Dunstan JA, Prescott SL. Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial. J Allergy Clin Immunol. 2007;119(1):184–91.

    PubMed  Google Scholar 

  33. Soh SE, Aw M, Gerez I, Chong YS, Rauff M, Ng YPM, et al. Probiotic supplementation in the first 6 months of life in at risk Asian infants—effects on eczema and atopic sensitization at the age of 1 year. Clin Exp Allergy. 2009;39(4):571–8.

    CAS  PubMed  Google Scholar 

  34. Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001;357(9262):1076–9.

    CAS  PubMed  Google Scholar 

  35. Allen SJ, Jordan S, Storey M, Thornton CA, Gravenor MB, Garaiova I, et al. Probiotics in the prevention of eczema: a randomised controlled trial. Arch Dis Child. 2014;99(11):1014–9.

    PubMed  Google Scholar 

  36. Kopp MV, Hennemuth I, Heinzmann A, Urbanek R. Randomized, double-blind, placebo-controlled trial of probiotics for primary prevention: no clinical effects of Lactobacillus GG supplementation. Pediatrics. 2008;121(4):e850–e856856.

    PubMed  Google Scholar 

  37. Niers L, Martin R, Rijkers G, Sengers F, Timmerman H, van Uden N, et al. The effects of selected probiotic strains on the development of eczema (the PandA study). Allergy. 2009;64(9):1349–58.

    CAS  PubMed  Google Scholar 

  38. Zhengchun G, et al. Probiotics have an early preventitive effect on the occurrence of atopic disease in children. Chin J Matern Child Health. 2004;11:120–1.

    Google Scholar 

  39. Nakata J, Hirota T, Umemura H, Nakagawa T, Kando N, Futamura M, et al. Additive effect of Lactobacillus acidophilus L-92 on children with atopic dermatitis concomitant with food allergy. Asia Pac Allergy. 2019;9(2):e18.

    PubMed  PubMed Central  Google Scholar 

  40. Woo SI, Kim JY, Lee YJ, Kim NS, Hahn YS. Effect of Lactobacillus sakei supplementation in children with atopic eczema-dermatitis syndrome. Ann Allergy Asthma Immunol. 2010;104(4):343–8.

    CAS  PubMed  Google Scholar 

  41. Yesilova Y, Calka O, Akdeniz N, Berktas M. Effect of probiotics on the treatment of children with atopic dermatitis. Ann Dermatol. 2012;24(2):189–93.

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Kim J, Han Y, Kim B, Ban J, Lee J, et al. Effects of Lactobacillus plantarum CJLP133 on pediatric atopic dermatitis: a double-blind, placebo-controlled trial. Allergy Eur J Allergy Clin Immunol. 2012;67:140–1.

    Google Scholar 

  43. Weston S, Halbert A, Richmond P, Prescott SL. Effects of probiotics on atopic dermatitis: a randomised controlled trial. Arch Dis Child. 2005;90(9):892–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Wu YJ, Wu WF, Hung CW, Ku MS, Liao PF, Sun HL, et al. Evaluation of efficacy and safety of Lactobacillus rhamnosus in children aged 4–48 months with atopic dermatitis: an 8-week, double-blind, randomized, placebo-controlled study. J Microbiol Immunol Infect. 2017;50(5):684–92.

    PubMed  Google Scholar 

  45. Gerasimov SV, Vasjuta VV, Myhovych OO, Bondarchuk LI. Probiotic supplement reduces atopic dermatitis in preschool children: a randomized, double-blind, placebo-controlled, clinical trial. Am J Clin Dermatol. 2010;11(5):351–61.

    PubMed  Google Scholar 

  46. Viljanen M, Savilahti E, Haahtela T, Juntunen-Backman K, Korpela R, Poussa T, et al. Probiotics in the treatment of atopic eczema/dermatitis syndrome in infants: a double-blind placebo-controlled trial. Allergy. 2005;60(4):494–500.

    CAS  PubMed  Google Scholar 

  47. Chernyshov PV. Randomized, placebo-controlled trial on clinical and immunologic effects of probiotic containing Lactobacillus rhamnosus R0011 and L. helveticus R0052 in infants with atopic dermatitis. Microbl Ecol Health Dis. 2009;21(3/4):228–32.

    CAS  Google Scholar 

  48. Kim SO, Ah YM, Yu YM, Choi KH, Shin WG, Lee JY. Effects of probiotics for the treatment of atopic dermatitis: a meta-analysis of randomized controlled trials. Ann Allergy Asthma Immunol. 2014;113(2):217–26.

    PubMed  Google Scholar 

  49. Chang YS, Trivedi MK, Jha A, Lin YF, Dimaano L, Garcia-Romero MT. Synbiotics for prevention and treatment of atopic dermatitis: a meta-analysis of randomized clinical trials. JAMA Pediatr. 2016;170(3):236–42.

    PubMed  Google Scholar 

  50. Jones CA, Holloway JA, Warner JO. Does atopic disease start in foetal life? Allergy. 2000;55(1):2–10.

    CAS  PubMed  Google Scholar 

  51. Landreth KS. Critical windows in development of the rodent immune system. Hum Exp Toxicol. 2002;21(9–10):493–8.

    CAS  PubMed  Google Scholar 

  52. Zhuang L, Chen H, Zhang S, Zhuang J, Li Q, Feng Z. Intestinal microbiota in early life and its implications on childhood health. Genom Proteom Bioinform. 2019;17:13–25.

    Google Scholar 

  53. Valles Y, Artacho A, Pascual-Garcia A, Ferrus ML, Gosalbes MJ, Abellan JJ, et al. Microbial succession in the gut: directional trends of taxonomic and functional change in a birth cohort of Spanish infants. PLoS Genet. 2014;10(6):e1004406.

    PubMed  PubMed Central  Google Scholar 

  54. Rodriguez JM, Murphy K, Stanton C, Ross RP, Kober OI, Juge N, et al. The composition of the gut microbiota throughout life, with an emphasis on early life. Microb Ecol Health Dis. 2015;26:26050.

    PubMed  Google Scholar 

  55. Milani C, Duranti S, Bottacini F, Casey E, Turroni F, Mahony J, et al. The first microbial colonizers of the human gut: composition, activities, and health implications of the infant gut microbiota. Microbiol Mol Biol Rev. 2017;81(4):e00036-17.

    PubMed  PubMed Central  Google Scholar 

  56. Gensollen T, Iyer SS, Kasper DL, Blumberg RS. How colonization by microbiota in early life shapes the immune system. Science. 2016;352(6285):539–44.

    CAS  PubMed  PubMed Central  Google Scholar 

  57. Björkstén B, Sepp E, Julge K, Voor T, Mikelsaar M. Allergy development and the intestinal microflora during the first year of life. J Allergy Clin Immunol. 2001;108(4):516–20.

    PubMed  Google Scholar 

  58. Sjögren YM, Jenmalm MC, Böttcher MF, Björkstén B, Sverremark-Ekström E. Altered early infant gut microbiota in children developing allergy up to 5 years of age. Clin Exp Allergy. 2009;39(4):518–26.

    PubMed  Google Scholar 

  59. Suzuki S, Kubota N, Kakiyama S, Miyazaki K, Sato K, Harima-Mizusawa N. Effect of Lactobacillus plantarum YIT 0132 on Japanese cedar pollinosis and regulatory T cells in adults. Allergy. 2020;75(2):453–6.

    PubMed  Google Scholar 

  60. La Rosa PS, Warner BB, Zhou Y, Weinstock GM, Sodergren E, Hall-Moore CM, et al. Patterned progression of bacterial populations in the premature infant gut. Proc Natl Acad Sci USA. 2014;111(34):12522–7.

    PubMed  PubMed Central  Google Scholar 

  61. Thaiss CA, Zmora N, Levy M, Elinav E. The microbiome and innate immunity. Nature. 2016;535(7610):65–74.

    CAS  PubMed  Google Scholar 

  62. Cantey JB, Wozniak PS, Pruszynski JE, Sanchez PJ. Reducing unnecessary antibiotic use in the neonatal intensive care unit (SCOUT): a prospective interrupted time-series study. Lancet Infect Dis. 2016;16(10):1178–84.

    PubMed  Google Scholar 

  63. Gregory KE, Samuel BS, Houghteling P, Shan G, Ausubel FM, Sadreyev RI, et al. Influence of maternal breast milk ingestion on acquisition of the intestinal microbiome in preterm infants. Microbiome. 2016;4(1):68.

    PubMed  PubMed Central  Google Scholar 

  64. Passeron T, Lacour JP, Fontas E, Ortonne JP. Prebiotics and synbiotics: two promising approaches for the treatment of atopic dermatitis in children above 2 years. Allergy. 2006;61(4):431–7.

    CAS  PubMed  Google Scholar 

  65. Costello SP, Hughes PA, Waters O, Bryant RV, Vincent AD, Blatchford P, et al. Effect of fecal microbiota transplantation on 8-week remission in patients with ulcerative colitis: a randomized clinical trial. JAMA. 2019;321(2):156–64.

    PubMed  PubMed Central  Google Scholar 

  66. Fontana L, Bermudez-Brito M, Plaza-Diaz J, Munoz-Quezada S, Gil A. Sources, isolation, characterisation and evaluation of probiotics. Br J Nutr. 2013;109(Suppl 2):S35–50.

    CAS  PubMed  Google Scholar 

  67. Mah KW, Chin VI, Wong WS, Lay C, Tannock GW, Shek LP, et al. Effect of a milk formula containing probiotics on the fecal microbiota of Asian infants at risk of atopic diseases. Pediatr Res. 2007;62(6):674–9.

    PubMed  Google Scholar 

  68. Kristensen NB, Bryrup T, Allin KH, Nielsen T, Hansen TH, Pedersen O. Alterations in fecal microbiota composition by probiotic supplementation in healthy adults: a systematic review of randomized controlled trials. Genome Med. 2016;8(1):52.

    PubMed  PubMed Central  Google Scholar 

  69. Bindels LB, Delzenne NM, Cani PD, Walter J. Towards a more comprehensive concept for prebiotics. Nat Rev Gastroenterol Hepatol. 2015;12(5):303–10.

    CAS  PubMed  Google Scholar 

  70. Guarner F, Khan AG, Garisch J, Eliakim R, Gangl A, Thomson A, et al. World Gastroenterology Organisation Global Guidelines: probiotics and prebiotics October 2011. J Clin Gastroenterol. 2012;46(6):468–81.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China

    Wen Jiang, Irene X. Y. Wu & Xingli Li

  2. Maternal and Child Health Care Hospital, Changsha of Hunan Province, Changsha, China

    Bin Ni, Zhiyu Liu, Xuan Liu & Wanqin Xie

Authors
  1. Wen Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bin Ni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhiyu Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xuan Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wanqin Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Irene X. Y. Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xingli Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Irene X. Y. Wu or Xingli Li.

Ethics declarations

Funding

The study was funded by Major Scientific and Technological Projects for Collaborative Prevention and Control of Birth Defects in Hunan Province (2019SK1012), Major Research and Development Projects in Hunan Province (2018SK2060), and Scientific and Technological Department Projects in Hunan Province (2017SK50802).

Conflict of interest

Wen Jiang, Bin Ni, Zhiyu Liu, Xuan Liu, Wanqin Xie, Irene X.Y. Wu, and Xingli Li have no conflicts of interest that are directly relevant to the content of this review.

Data availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

Author contributions

WJ and XL developed the research question. WX and ZL conducted the literature search. WJ, BN, WX, and XL selected the literature, extracted the data, and assessed the risk of bias. IXYW and WX analyzed the data, and IXYW and WJ interpreted the results. WJ, IXYW, and XL wrote the manuscript. All authors contributed to the interpretation and revision of the manuscript.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 923 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jiang, W., Ni, B., Liu, Z. et al. The Role of Probiotics in the Prevention and Treatment of Atopic Dermatitis in Children: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pediatr Drugs 22, 535–549 (2020). https://doi.org/10.1007/s40272-020-00410-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40272-020-00410-6

Search

Navigation