Researchers tested whether probiotics (helpful bacteria) could help children with severe blood infections recover better in the hospital. They gave some very sick children probiotics for a week while others got a fake treatment. The study found that probiotics did reduce certain inflammation markers in the blood, which is a good sign. However, the probiotics didn’t clearly help with other important measures like how long kids stayed in the hospital or how many got better. While the results are interesting, doctors need more research before recommending probiotics as a standard treatment for this serious condition.

The Quick Take

  • What they studied: Whether giving probiotics (good bacteria) to very sick children with serious blood infections would help reduce gut damage and improve their recovery
  • Who participated: Children admitted to intensive care units with severe blood infections (sepsis). The exact number of children wasn’t specified in the abstract, but they were randomly assigned to receive either probiotics or a placebo (fake treatment) for 7 days
  • Key finding: Probiotics reduced inflammation markers in the blood (IL-6 dropped by 25% and IL-10 increased significantly), but didn’t clearly improve gut barrier markers or major health outcomes like hospital stay length or survival rates
  • What it means for you: While probiotics showed some promise in reducing inflammation in very sick children, there’s not yet enough evidence to recommend them as a standard treatment. Parents of critically ill children should discuss any probiotic use with their medical team, as more research is needed

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of medical research. Researchers took children admitted to pediatric intensive care units with severe blood infections and randomly divided them into two groups. One group received probiotics (2 billion colony-forming units daily) for 7 days, while the other group received a placebo (a fake treatment that looked identical). Neither the doctors nor the families knew which children got the real probiotics, which is called “double-blind” and helps prevent bias.

The researchers measured several things to see if probiotics helped: they checked blood markers that show gut damage (zonulin and LBP), measured inflammation chemicals in the blood (IL-6, IL-10, and CRP), tracked organ function, and monitored hospital outcomes like how long children stayed in the ICU and whether they survived. This comprehensive approach allowed them to see if probiotics worked at multiple levels.

The double-blind, randomized design is important because it reduces the chance that expectations or bias influenced the results. By measuring both gut-specific markers and broader health outcomes, researchers could see whether probiotics worked at the cellular level and whether those improvements translated to real health benefits for the children

This study has several strengths: it used a proper control group, was double-blind, and measured multiple important outcomes. However, the abstract doesn’t specify how many children participated, which makes it hard to judge if the study was large enough to find real effects. The fact that some results showed statistical significance (inflammation markers) while others didn’t (gut markers and major outcomes) suggests the study may have been underpowered for some measurements. This is described as a ‘preliminary’ study, meaning more research is needed before drawing firm conclusions

What the Results Show

After one week of treatment, the probiotic group showed lower levels of zonulin and LBP (markers of gut damage) compared to the placebo group, but these differences were not statistically significant. This means the differences could have been due to chance rather than the probiotics actually working.

However, when looking at inflammation markers, probiotics did show clear benefits. The IL-6 inflammation marker dropped by about 25% in the probiotic group compared to placebo (P=0.001, meaning this result is very unlikely to be due to chance). Additionally, IL-10, which is a protective anti-inflammatory marker, increased significantly more in the probiotic group (P<0.001). These changes suggest probiotics may help calm down the body’s excessive inflammatory response during severe infection.

Despite these positive changes in inflammation markers, there were no significant differences between groups for other important outcomes. The probiotic group did not show better results for organ function scores, need for breathing machines, development of multiple organ failure, or septic shock. Hospital and ICU stay lengths were similar between groups, as was the mortality rate.

The study found no differences between probiotic and placebo groups for: C-reactive protein (another inflammation marker), organ failure assessment scores, need for mechanical ventilation, development of multiple organ dysfunction, septic shock rates, hospital-acquired infections, length of ICU or hospital stays, or hospital mortality rates. Importantly, no serious side effects were reported in children receiving probiotics, suggesting they were safe to use in this population

Previous research on probiotics in critically ill patients has shown mixed results. Some studies suggested benefits for reducing infections and shortening hospital stays, while others found minimal impact. This study’s finding of reduced inflammation markers aligns with some previous research suggesting probiotics may modulate immune response, but the lack of improvement in major clinical outcomes is consistent with other recent studies questioning whether these inflammation changes translate to real patient benefits

The study has several important limitations: the sample size is not specified, making it unclear if the study was large enough to detect real effects; the study is described as ‘preliminary,’ suggesting it may be ongoing or incomplete; the short 7-day treatment period may not be long enough to see full benefits; the study only measured outcomes for 7 days, so longer-term effects are unknown; and the lack of improvement in major clinical outcomes (mortality, hospital stay) despite inflammation improvements raises questions about whether the measured changes are clinically meaningful

The Bottom Line

Based on this preliminary research, probiotics cannot yet be recommended as a standard treatment for sepsis in critically ill children (low confidence level). While the inflammation-reducing effects are interesting, they didn’t translate to better hospital outcomes. Parents and doctors should not expect probiotics to improve survival rates or shorten hospital stays based on current evidence. Any use of probiotics in critically ill children should only occur under medical supervision and as part of research studies

This research is most relevant to: parents of children in pediatric intensive care units with severe infections, pediatric intensivists and critical care doctors, and researchers studying sepsis treatment. This research should NOT be used by parents to self-treat children at home with probiotics for infections. General pediatricians may want to follow this research but shouldn’t change current practice based on these preliminary results

This study measured changes over 7 days. If probiotics were to help, some inflammation changes appeared within this timeframe. However, major health outcomes like hospital discharge and survival would take weeks to months to fully assess. Realistic expectations would be to see any potential benefits over 2-4 weeks of treatment, though this study suggests major clinical benefits may not occur

Want to Apply This Research?

  • For families with children in ICU, track daily inflammatory markers if available (IL-6, IL-10, CRP levels from blood work), organ function scores (SOFA scores), and ventilator status. This allows monitoring of the specific changes this study measured
  • If a child is enrolled in a probiotic research study in the ICU, ensure consistent daily administration and track any side effects or tolerance issues. Communicate regularly with the medical team about any changes in the child’s condition
  • Long-term tracking should focus on major health outcomes: length of ICU stay, length of hospital stay, need for mechanical ventilation, development of organ failure, and ultimately hospital discharge status and health status at 30 days post-discharge. These are the outcomes that matter most for patient care

This research is preliminary and should not be used to guide treatment decisions for critically ill children. Probiotics should only be given to children in intensive care under direct medical supervision and as part of approved clinical studies. This study does not provide evidence that probiotics improve survival or major health outcomes in sepsis. Parents should always consult with their child’s medical team before considering any supplements or treatments. This summary is for educational purposes only and does not constitute medical advice.