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Oral purified bacterial extracts in acute respiratory tract infections in childhood: a systematic quantitative review

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Abstract

Background

Recurrent acute respiratory tract infections (ARTI) are a common problem in childhood. Some evidence suggests a benefit regarding the prevention of ARTI in children treated with the immunomodulator OM-85 BV (Bronchovaxom).

Methods

We summarised the evidence on the effectiveness of the immunomodulator OM-85 BV in the prevention of ARTI in children. We searched randomised comparisons of oral purified bacterial extracts against inactive controls in children with respiratory tract diseases in nine electronic databases and reference lists of included studies. We extracted salient features of each study, calculated relative risks (RR) or weighted mean differences (WMD) and performed meta-analyses using random-effects models.

Results

Thirteen studies (2,721 patients) of low to moderate quality tested OM-85 BV. Patients and outcomes differed substantially, which impeded pooling results of more than two trials. Two studies (240 patients) reporting on the number of patients with less than three infections over 6 month of follow-up in children not in day care showed a trend for benefit RR 0.82 (95% CI, 0.65–1.02). One out of two studies examining the number of children not in day care without infections over 4–6 month reported a significant RR of 0.42 (95% CI, 0.21–0.82) whereas the smaller, second study did not [RR 0.92 (95% CI, 0.58–1.46)]. Two studies reporting the number of antibiotic courses indicated a benefit for the intervention arm [WMD 2.0 (95% CI, 1.7–2.3)]. Two out of the three studies showed a reduction of length of episodes of 4–6 days whereas a third study showed no difference between the two groups.

Conclusion

Evidence in favour of OM-85 BV in the prevention of ARTI in children is weak. There is a trend for fewer and shorter infections and a reduction of antibiotic use.

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Acknowledgements

We thank Dr. P. Estermann, information specialist from the Library Service of the Zurich University Hospital, for his help in searching electronic databases.

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Authors and Affiliations

  1. Medical Policlinic, Department of Internal Medicine, University Hospital, Raemistrasse 100, CH-8091, Zurich, Switzerland

    Claudia Steurer-Stey

  2. Horten Centre for Patient Oriented Research, University of Zurich, Zurich, Switzerland

    Leonie Lagler, Johann Steurer & Lucas M. Bachmann

  3. Children University Hospital, Zurich, Switzerland

    Daniel A. Straub

  4. Division of Epidemiology and Biostatistics, Institute for Social and Preventative Medicine, University of Bern, Bern, Switzerland

    Lucas M. Bachmann

Authors
  1. Claudia Steurer-Stey
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  2. Leonie Lagler
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  3. Daniel A. Straub
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  4. Johann Steurer
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  5. Lucas M. Bachmann
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Corresponding author

Correspondence to Claudia Steurer-Stey.

Additional information

CS initiated the project and is the study guarantor. CS and LL searched and extracted the data. DS cross-checked extracted data. LMB and JS cross-checked and analysed extracted data. All authors participated in discussing the results and writing the paper.

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Steurer-Stey, C., Lagler, L., Straub, D.A. et al. Oral purified bacterial extracts in acute respiratory tract infections in childhood: a systematic quantitative review. Eur J Pediatr 166, 365–376 (2007). https://doi.org/10.1007/s00431-006-0248-3

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  • DOI: https://doi.org/10.1007/s00431-006-0248-3

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