Date of Award

2013

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not probiotic supplementation is effective in reducing the incidence of atopic dermatitis in children age 3 and younger.

STUDY DESIGN: Systematic review of three Engligh language primary studies one published in 2009 and the other two in 2010.

DATA SOURCES: Three double blind randomized controlled trials comparing the efficacy of probiotic supplementation for reducing the incidence of atopic dermatitis in children ages 3 and under were found using Cochrane Library EBM and PubMed databases.

OUTCOMES MEASURED: Diagnosis of atopic dermatitis, via a positive skin-prick-test result or elevated specific immunoglobulin E [IgE] level , Atopic dermatitis severity using SCORAD scores pre/post intervention , and parental reported weekly diaries of the health status subjects, a British Medical Research Council questionnaire and the Dutch European community Respiratory Health
Survey.

RESULTS: Minimal intervention-related adverse events were reported in the studies, and included feeding problems, formula intolerance, and the need for corticosteroid treatment. Niers et al showed in the first 3 months, parental reported incidence of atopic dermatitis was significantly lower in the probiotic group 6/50 compared to the placebo group15/52, and p=0.035. Gruber et al
demonstrated after 1 year, atopic dermatitis occurred in fewer infants from the probiotic group, (5.7%) than from the control group (9.7%), p=0.04 and CI is 95% and is narrow. Dotterud et al demonstrated at 2 years of age, probiotic intervention group showed 29/138 subjects were assessed as having atopic dermatitis(21%.) In the placebo group 48/140 were assessed as having atopic dermatitis (34.3%). The Odds ratio of the cumulative incidence of atopic dermatitis was calculated to be 0.51 and the p value was equal to 0.013. The p value calculated determined that the incidence of atopic dermatitis in the
probiotc group versus the placebo group was statistically significant (p<0.05).

CONCLUSION: All three studies showed that probiotic supplementation is effective in reducing the incidence of atopic dermatitis in children age 3 and under.

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