Lactobacillus salivarius plus fructo-oligosaccharide is superior to fructo-oligosaccharide alone for treating children with moderate to severe atopic dermatitis: a double-blind, randomized, clinical trial of efficacy and safety

Br J Dermatol. 2012 Jan;166(1):129-36. doi: 10.1111/j.1365-2133.2011.10596.x. Epub 2011 Dec 6.


Background: Some probiotics can ameliorate childhood atopic dermatitis (AD). Prebiotics have also shown some efficacy, although when combined with probiotics as synbiotics, their efficacy may improve.

Objective: We compared the effects of Lactobacillus salivarius and fructo-oligosaccharide (synbiotic) with fructo-oligosaccharide alone (prebiotic) on children with moderate to severe AD.

Methods: We randomly assigned 60 children aged 2-14years with moderate to severe AD [SCORing AD (SCORAD)>25] to a treatment (synbiotic) or a control (prebiotic) group (30 per group). They received one capsule twice daily for 8weeks containing either L. salivarius plus fructo-oligosaccharide (treatment) or fructo-oligosaccharide only (control). SCORAD indices were monitored at weeks 0, 4, 8 and 10 (post-treatment). Laboratory results and AD medication use were also monitored.

Results: Baseline demographic and clinical characteristics and SCORAD scores were similar between the two groups. At 8weeks, the treatment group SCORAD scores (27·4±12·7) were significantly lower than for the controls (36·3±14·9) (P=0·022); this difference remained at 10weeks. At 8weeks, treatment group AD intensity was significantly lower (P=0·013); more children had mild AD in the treatment group (52%; 14/27) than the control group (30%; 8/27) (P=0·024). Medication use frequency and eosinophil cationic protein levels were significantly reduced in the treatment group at 8weeks compared with 4 weeks.

Conclusion: A synbiotic combination of L. salivarius plus fructo-oligosaccharide is superior to the prebiotic alone for treating moderate to severe childhood AD. However, continued follow-up will be necessary to ascertain long-term benefits.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Capsules
  • Child
  • Child, Preschool
  • Dermatitis, Atopic / therapy*
  • Double-Blind Method
  • Eosinophil Cationic Protein / metabolism
  • Female
  • Humans
  • Lactobacillus*
  • Male
  • Oligosaccharides / therapeutic use*
  • Prebiotics*
  • Quality of Life
  • Synbiotics*
  • Treatment Outcome


  • Capsules
  • Oligosaccharides
  • Prebiotics
  • Eosinophil Cationic Protein