The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Effectiveness of the probiotic Streptococcus salivarius K12 for the treatment and/or prevention of sore throat: a systematic review

Effectiveness of the probiotic Streptococcus salivarius K12 for the treatment and/or prevention of sore throat: a systematic review
Effectiveness of the probiotic Streptococcus salivarius K12 for the treatment and/or prevention of sore throat: a systematic review
Background

Sore throat resulting from pharyngotonsillitis is one of the commonest reasons for primary care consultation and inappropriate antibiotic prescription and finding effective alternative treatments is important.

Objectives

To review the evidence for using the probiotic Streptococcus salivarius K12 (SsK12) for the prevention or treatment of pharyngotonsillitis.

Data Sources

PubMed, Embase, CINAHL and Cochrane Library.

Study eligibility criteria

Randomized controlled trials (RCTs).

Participants

Adults or children.

Interventions

SsK12 as active treatment or prophylaxis, against pharyngotonsillitis.

Methods

Literature search.

Results

Four articles were identified (1846 participants). All were deemed to be of poor quality using the Cochrane risk-of-bias assessment. Two trials studied SsK12 prophylaxis for streptococcal pharyngitis (children without history of recurrence). One compared daily administration of SsK12 to no treatment over 6 months (n = 222, age 33–45 months), reporting significantly lower incidence in the SsK12 group (16.2% vs. 48.6%, p < 0.01), whereas another placebo-controlled RCT over four school terms (n = 1314, 5–14 years) found no significant difference (7.8% vs. 8.8%, p 0.34) with SsK12 (administered on school days). Another trial found daily SsK12 to significantly protect children (n = 250, 6–7 years) against chronic adenoiditis exacerbation over 3 months compared to no treatment (71.7% vs. 100%, p < 0.0001). The one placebo-controlled RCT in adults that studied the use of SsK12 for acute pharyngotonsillitis (concurrently with penicillin) showed no significant benefit. In all trials, SsK12 was safe and well tolerated.

Conclusions

SsK12 appears safe and well tolerated. However, further RCTs are required to establish its role as a prophylactic therapy, particularly among patients experiencing frequent exacerbations of pharyngitis. In the acute setting, SsK12 is unlikely to be effective if given concurrently with antibiotics; however, further RCTs should establish its role as an alternative to antibiotics in nonsevere cases or when prescribed after antibiotic therapy for the prevention of disease recurrence and/or secondary infection.

1198-743X
Wilcox, Christopher
8975090d-75a6-49dc-b57e-cf2ff4cb4a0c
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Leaver, Hannah
097d7f3a-6c66-4f94-94ae-e856f2e20561
Lown, Mark
4742d5f8-bcf3-4e0b-811c-920e7d010c9b
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Wilcox, Christopher
8975090d-75a6-49dc-b57e-cf2ff4cb4a0c
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Leaver, Hannah
097d7f3a-6c66-4f94-94ae-e856f2e20561
Lown, Mark
4742d5f8-bcf3-4e0b-811c-920e7d010c9b
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

Wilcox, Christopher, Stuart, Beth, Leaver, Hannah, Lown, Mark, Willcox, Merlin, Moore, Michael and Little, Paul (2019) Effectiveness of the probiotic Streptococcus salivarius K12 for the treatment and/or prevention of sore throat: a systematic review. Clinical Microbiology and Infection. (doi:10.1016/j.cmi.2018.12.031).

Record type: Article

Abstract

Background

Sore throat resulting from pharyngotonsillitis is one of the commonest reasons for primary care consultation and inappropriate antibiotic prescription and finding effective alternative treatments is important.

Objectives

To review the evidence for using the probiotic Streptococcus salivarius K12 (SsK12) for the prevention or treatment of pharyngotonsillitis.

Data Sources

PubMed, Embase, CINAHL and Cochrane Library.

Study eligibility criteria

Randomized controlled trials (RCTs).

Participants

Adults or children.

Interventions

SsK12 as active treatment or prophylaxis, against pharyngotonsillitis.

Methods

Literature search.

Results

Four articles were identified (1846 participants). All were deemed to be of poor quality using the Cochrane risk-of-bias assessment. Two trials studied SsK12 prophylaxis for streptococcal pharyngitis (children without history of recurrence). One compared daily administration of SsK12 to no treatment over 6 months (n = 222, age 33–45 months), reporting significantly lower incidence in the SsK12 group (16.2% vs. 48.6%, p < 0.01), whereas another placebo-controlled RCT over four school terms (n = 1314, 5–14 years) found no significant difference (7.8% vs. 8.8%, p 0.34) with SsK12 (administered on school days). Another trial found daily SsK12 to significantly protect children (n = 250, 6–7 years) against chronic adenoiditis exacerbation over 3 months compared to no treatment (71.7% vs. 100%, p < 0.0001). The one placebo-controlled RCT in adults that studied the use of SsK12 for acute pharyngotonsillitis (concurrently with penicillin) showed no significant benefit. In all trials, SsK12 was safe and well tolerated.

Conclusions

SsK12 appears safe and well tolerated. However, further RCTs are required to establish its role as a prophylactic therapy, particularly among patients experiencing frequent exacerbations of pharyngitis. In the acute setting, SsK12 is unlikely to be effective if given concurrently with antibiotics; however, further RCTs should establish its role as an alternative to antibiotics in nonsevere cases or when prescribed after antibiotic therapy for the prevention of disease recurrence and/or secondary infection.

Text
Salivarius review CMI R1 - Accepted Manuscript
Download (130kB)

More information

Accepted/In Press date: 23 December 2018
e-pub ahead of print date: 4 January 2019

Identifiers

Local EPrints ID: 427181
URI: http://eprints.soton.ac.uk/id/eprint/427181
ISSN: 1198-743X
PURE UUID: 5640175d-d6ef-4543-b74f-3b09292cacb9
ORCID for Beth Stuart: ORCID iD orcid.org/0000-0001-5432-7437
ORCID for Mark Lown: ORCID iD orcid.org/0000-0001-8309-568X
ORCID for Merlin Willcox: ORCID iD orcid.org/0000-0002-5227-3444
ORCID for Michael Moore: ORCID iD orcid.org/0000-0002-5127-4509

Catalogue record

Date deposited: 04 Jan 2019 17:30
Last modified: 09 Jan 2022 07:43

Export record

Altmetrics

Contributors

Author: Christopher Wilcox
Author: Beth Stuart ORCID iD
Author: Hannah Leaver
Author: Mark Lown ORCID iD
Author: Merlin Willcox ORCID iD
Author: Michael Moore ORCID iD
Author: Paul Little

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×