Conclusion : Based on the available data and taking into account the safety profile of RCTs , probiotic consumption appears to be a feasible way to decrease the incidence of RTIs in children
Background : Respiratory tract infections ( RTIs ) represent one of the main health problems in children .
Probiotics are viable bacteria that colonize the intestine and affect the host intestinal microbial balance .
Accumulating evidence suggests that probiotic consumption may decrease the incidence of or modify RTIs .
The authors systematic ally review ed data from r and omized controlled trials ( RCTs ) to investigate the effect of probiotic consumption on  RTIs in children .
Spray bacteriotherapy decreases middle ear fluid in children with secretory otitis media
Objective : Secretory otitis media ( SOM ) is characterised by persistent fluid in the middle ear cavity , but the cause is unknown . We investigated the clinical , bacteriological and immunological effects of treatment with probiotic bacteria on SOM . Design : In this double-blind pilot/preliminary study , 60 children with long-st and ing SOM ( median 6 months ) who were scheduled for insertion of tympanostomy tubes  were r and omised to nasal spray treatment with Streptococcus sanguinis , Lactobacillus rhamnosus or placebo for 10 days before surgery .  Clinical evaluation was carried out after 10 days of treatment . Middle ear fluid ( MEF ) was collected during surgery for quantification of cytokines and detection of bacteria by culture and polymerase chain reaction ( PCR ) . Nasopharyngeal swabs were obtained before treatment and at surgery . Results : Complete or significant clinical recovery occurred in 7/19 patients treated with S sanguinis compared to 1/17 patients in the placebo group ( p<0.05 ) . In the L rhamnosus treatment group , 3/18 patients were cured or much better ( p = 0.60 compared with placebo ) . Spray treatment did not alter the composition of the nasopharyngeal flora or the cytokine pattern observed in the nasopharynx or MEF , except for a higher level of IL-8 found in the nasopharynx of L rhamnosus treated children . Conclusions : This study shows that spray treatment with S sanguinis may be effective against SOM . The mechanism for the effect remains to be investigated
Conclusion : Based on the available data and taking into account the safety profile of RCTs , probiotic consumption appears to be a feasible way to decrease the incidence of RTIs in children
Background : Respiratory tract infections ( RTIs ) represent one of the main health problems in children .
Probiotics are viable bacteria that colonize the intestine and affect the host intestinal microbial balance .
Accumulating evidence suggests that probiotic consumption may decrease the incidence of or modify RTIs .
The authors systematic ally review ed data from r and omized controlled trials ( RCTs ) to investigate the effect of probiotic consumption on  RTIs in children .