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Prebiotics and synbiotics: two promising approaches for the treatment of atopic dermatitis in children above 2 years


Passeron Thierry
Department of Dermatology
Archet 2 Hospital
BP 3079
06202 Nice
Cedex 3


Background:  Appropriate use of prebiotics and optimal combinations of probiotics and prebiotics (synbiotics) could allow significantly better results to be obtained in the treatment of atopic dermatitis (AD).

Objective:  To evaluate the efficiency of synbiotics when compared with prebiotics alone (control group) in the treatment of moderate and severe AD in children aged 2 years and over.

Methods:  Double-blind prospective randomized study performed on children aged at least 2 years presenting AD with a minimum SCORing Atopic Dermatitis (SCORAD) score of 15. A dose of 1.2 × 109 colony-forming units Lactobacillus rhamnosus Lcr35 plus prebiotic preparation or an identically appearing prebiotic preparation alone was given three times a day for 3 months. Patients’ diet and usual treatment for AD remained unchanged during the study period. Efficiency was evaluated using the SCORAD score. Use of topical drugs was noted.

Results:  A total of 48 patients were originally enrolled; nine did not complete the study. In synbiotic group, the mean values of the total SCORAD score was 39.1 before treatment vs 20.7 after 3 months of treatment (P < 0.0001). In the prebiotic group, the mean of the total SCORAD score was 39.3 before the treatment vs 24.0 after 3 months (P < 0.0001). After 3 months of treatment, no statistical differences between the two treatment groups with regard to the total SCORAD score were noted (P = 0.535). Neither were there any statistical differences in the total use of ointment between patients receiving prebiotics or synbiotics (P = 0.966) over the study period. Tolerance was excellent in both groups.

Conclusions:  Both synbiotics and prebiotics used alone seem able to significantly improve the manifestations of AD in children aged 2 years and over.