The Effect of the Oral Probiotic Streptococcus salivarius (K12) on Group A Streptococcus Pharyngitis: A Pragmatic Trial In Schools.

The Effect of the Oral Probiotic Streptococcus salivarius (K12) on Group A Streptococcus Pharyngitis: A Pragmatic Trial In Schools.

Pediatr Infect Dis J. 2017 Nov 15;:

Authors: Doyle H, Pierse N, Tiatia R, Williamson D, Baker M, Crane J

Abstract
BACKGROUND: The aim of this study was to examine the effectiveness of the oral probiotic S. salivarius K12 (K12) in preventing Group A streptococcus (GAS) pharyngitis in 5-14 year old children at high risk of acute rheumatic fever (ARF). New Zealand has high rates of ARF amongst Māori and Pacific children. Children were already enrolled in a school based Ministry of Health throat swabbing and treatment program. Children self-identified and reported sore throats daily and were swabbed twice weekly.
METHODS: 1314 children were quasi-randomized (based on odd or even birthdates) to receive either K12 (2.5 x 10 cfu's per lozenge) or placebo lozenges and continued observed daily treatment (in the school week, during school time) for one school year.
RESULTS: 801 children (61.0%) reported a sore throat on one or more occasions resulting in 2927 pharyngeal swabs. Of these swabs, 1525 (52.1%) were taken from 411 children receiving K12 and 119 (7.8%) of these were positive for GAS on routine culture. 1402 (47.8%) swabs were taken from 390 children receiving placebo and 124 (8.8%) were positive. Overall there was a non-significant 11.2% relative reduction in positive swabs amongst children receiving K12. This relative reduction was greater for older children, aged 7-9 years, 15.6%, and for children 10 years and older, 30.2%.
CONCLUSIONS: S. salivarius (K12) had modest non-significant effects on culture-positive sore throats when given at school, during the school day. Based on our pragmatic trial, the routine use of this probiotic in the prevention of pharyngitis associated with GAS detection is not supported.

PMID: 29189607 [PubMed - as supplied by publisher]

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