L. rhamnosus from birth may reduce later eczema.

BEVERLY HILLS, CALIF. -- Children who took daily doses of Lactobacillus rhamnosus from birth had about half the rate of eczema at 2 years of age as did children taking placebo or children taking Bifidobacterium lactis, according to a double-blind study of 512 subjects.

On the other hand, there were no associations between either of the probiotic preparations and the development of atopy, Dr. Kristin Wickens reported in a poster presentation at the International Probiotics Association World Congress.

The investigators randomized 512 pregnant women to receive daily doses of either L. rhamnosus strain HN001 (6 x [10.sup.9] colony-forming units per day), B. lactis strain HN019 (9 x [10.sup.9] CFU / day), or placebo beginning at 35 weeks' gestation and continuing until 6 months post partum if the women were breast-feeding.

Beginning at birth, their infants received daily doses of the same probiotics or placebo. The investigators evaluated the children for eczema prevalence and severity at 3, 6, 12, 18, and 24 months. In addition, investigators assessed atopy using skin-prick tests at the age of 2 years.

The groups did not differ significantly on any demographic variable, including family history of eczema or allergic disease, ethnicity, or whether and for how long the children were breast-fed. At the end of 2 years, children receiving L. rhamnosus showed a 49% reduced risk of developing eczema and a 43% reduced risk of developing severe eczema, compared with placebo.

Severe eczema was defined as a SCORAD value of 10 or above. Both of the hazard ratios (0.51 and 0.57, respectively) in this univariate analysis were statistically significant, wrote Dr. Wickens of the University of Otago, Wellington, New Zealand, and her colleagues.

In contrast, there was no significant effect of B. lactis on eczema prevalence (hazard ratio of 0.90) or severity (hazard ratio of 0.99), compared with placebo.

Compared with children taking placebo, those taking L. rhamnosus had a hazard ratio of 0.74 for atopy. Those taking B. lactis had a hazard ratio of 0.82 for atopy. Neither value was statistically significant.

The three groups showed no significant differences in any gastrointestinal adverse event including antibiotic-related diarrhea, other diarrhea, reflux, vomiting, or "tummy ache." There were also no differences among the groups on anthropometric measurements including weight, length, and head circumference from birth through 24 months.

The study was funded by the Health Research Council of New Zealand and Fonterra New Zealand, a large dairy cooperative. Fonterra also provided the probiotics.

BY ROBERT FINN

San Francisco Bureau