A clinical trial conducted by Bettocchi and colleagues demonstrated that a probiotic mixture can significantly reduce the duration of fever in children with upper respiratory tract infections (URTIs). The findings, published in JAMA Network Open, indicate that children who received the probiotic formulation experienced a median fever reduction of two days compared to those given a placebo.
URTIs are among the most common illnesses affecting young children, with reports suggesting that children experience between five and eight episodes annually, particularly within the first five years of life. Fever is a common symptom of these infections and a leading cause of healthcare visits. The inappropriate use of antibiotics remains a major concern, as most URTIs are viral in nature and do not require antibiotic treatment.
Conventional symptom management strategies involve the use of antipyretics such as acetaminophen (paracetamol), which help temporarily lower body temperature but do not shorten the duration of fever. Probiotics have gained interest due to their potential role in modulating immune responses, though clinical evidence regarding their effectiveness in treating respiratory infections remains limited.
The study was designed as a triple-blind, placebo-controlled randomized clinical trial to assess whether a probiotic mixture could influence fever duration in children diagnosed with URTIs. Conducted at a pediatric emergency department in Milan, the trial included children aged 28 days to four years who presented with a fever of at least 38.5°C. A total of 87 children participated in the study, with 37 receiving the probiotic mixture and 50 receiving a placebo over a 14-day period.
The study revealed that children in the probiotic group had a significantly shorter fever duration compared to those in the placebo group. The median fever duration was three days in the probiotic group versus five days in the placebo group. Poisson regression analysis, adjusted for variables such as age, sex, and antibiotic use, indicated that probiotic supplementation was associated with a fever duration risk ratio of 0.64.
Adverse events were minimal and comparable between the two groups, with minor issues such as constipation and abdominal pain reported infrequently. The study found no significant differences in antibiotic prescription rates or the incidence of antibiotic-associated diarrhea between the probiotic and placebo groups. No safety concerns were identified, further supporting the tolerability of the probiotic mixture. Similarly, a study by Ozen et al concluded that probiotics were associated with a reduced incidence of URTIs and a decrease in antibiotic use.
In line with these findings, a systematic review of randomized controlled trials conducted between January 2010 and January 2020 evaluated the effects of probiotics on respiratory tract infections (RTIs). The review analyzed 27 clinical trials involving 9433 RTI patients and 10 ongoing studies on probiotics in COVID-19. Findings indicated that probiotics could enhance plasma cytokine levels, improve influenza vaccine efficacy, and boost quality of life while reducing viral titers, as well as the incidence and duration of RTIs. These antiviral and immune-modulating properties, along with their ability to stimulate interferon production, suggest that probiotics may serve as an adjunctive therapy for COVID-19 prevention.
While previous research has predominantly focused on probiotics in the prevention of respiratory infections, this study provides evidence of their potential therapeutic role as an adjunct treatment for pediatric URTIs. The findings suggest that probiotics could be a valuable addition to current management strategies, offering a natural and effective means to reduce fever duration in young children.
References
- Bettocchi S, Comotti A, Elli M, De Cosmi V, Berti C, Alberti I, et al. Probiotics and Fever Duration in Children With Upper Respiratory Tract Infections: A Randomized Clinical Trial. JAMA Network Open. 2025 Mar 14;8(3):e250669.
- Ozen M, Kocabas Sandal G, Dinleyici EC. Probiotics for the prevention of pediatric upper respiratory tract infections: a systematic review. Expert Opin Biol Ther. 2015 Jan;15(1):9–20.
- Darbandi A, Asadi A, Ghanavati R, Afifirad R, Darb Emamie A, Kakanj M, Talebi M. The effect of probiotics on respiratory tract infection with special emphasis on COVID-19: Systemic review 2010-20. Int J Infect Dis. 2021 Apr;105:91-104.