Oral bacteriotherapy in children with recurrent respiratory infections: a real-life study

Oral bacteriotherapy in children with recurrent respiratory infections: a real-life study


  • Vincenzo Tarantino Dipartimento Testa-Collo e Neuroscienze - IRCCS Istituto Giannina Gaslini, Genoa, Italy
  • Valentina Savaia Dipartimento Testa-Collo e Neuroscienze - IRCCS Istituto Giannina Gaslini, Genoa, Italy
  • Roberto D'Agostino Dipartimento Testa-Collo e Neuroscienze - IRCCS Istituto Giannina Gaslini, Genoa, Italy
  • Valerio Damiani Medical Department, DMG, Pomezia, Italy
  • Giorgio Ciprandi Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy


recurrent respiratory infections, bacteriotherapy, Streptococcus salivarius 24SMB, Streptococcus oralis89a, oral spray, children


Children with recurrent respiratory infections (RRI) represent a social issue for the economic burden and the familiar negative impact. Bacteriotherapy, such as the administration of “good” bacteria, is a new therapeutic strategy that could be potentially effective in preventing infections. The current study tested the hypothesis of preventing RRI by oral Bacteriotherapy in a real-life setting. This open study was conducted in an outpatient clinic, enrolling 51 children (27 males, mean age 4.8 ± 2.6 years) suffering from RRI. Children were treated with an oral spray, containing Streptococcus salivarius 24SMB and Streptococcus oralis89a (125 x 109 CFU/g), 2 puffs per os once/day for 30 consecutive days; this course was repeated for 3 months. The evaluated parameters were: RI number and school absences reported in the current year; these outcomes were compared with those recorded in the past year. The mean number of RI significantly diminished: from 5.17 (2.30) in the past year to 2.25 (2.43) after the treatment (p<0.0001). The mean number of school absences significantly diminished (from 3.35 to 1.86; p<0.0001). In conclusion, this real-life study suggests that oral Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis89a could efficaciously and safely prevent RRI in children.


1. de Martino M, Ballotti S. The child with recurrent respiratory infections: normal or not? Ped Allergy Immunol 2007;18(Suppl. 18):13-8
2. de Benedictis FM, Bush A. Recurrent lower respiratory tract infections in children. BMJ 2018;362:k2698
3. Mansback AI, Brihave P, Casimir G, et al. Clinical aspects of chronic ENT inflammation in children. B. ENT 2012;8 (Suppl 19), 83-101
4. Orlandi RR, Kingdom TT, Hwang PH, et al. International Consensus Statement on Allergy and Rhinology: Rhinosinusitis. Int Forum Allergy Rhinol. 2016;6 Suppl1: S22-209
5. Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012;50(1):1-12
6. Gisselson-Solen M. Acute otitis media in children – current treatment and prevention. Curr Infect Dis Rep 2015;17:22
7. Li J, Song X, Yang T, Chen Y, Gong Y, Yin X, Lu Z. A Systematic Review of Antibiotic Prescription Associated With Upper Respiratory Tract Infections in China. Medicine (Baltimore) 2016; 95(19):e3587
8. Marsh RL, Aho C, Beissbarth J, Bialasiewicz S, Binks M, Cervin A, et al. Recent Advances in Understanding the Natural History of the Otitis Media Microbiome and Its Response to Environmental Pressures. Int J Pediatr Otorhinolaryngol 2020 (in press)
9. Yamanishi S, Pawankar R. Current Advances on the Microbiome and Role of Probiotics in Upper Airways Disease. Curr Opin Allergy Clin Immunol 2020;20:30-5
10. Marchisio P, Nazzari E, Torretta S, Esposito S, Principi N. Medical prevention of recurrent acute otitis media: an updated overview. Expert Rev Anti Infect Ther 2014;12(4):611-20
11. Marchisio P, Santagati M, Scillato M, et al. Streptococcus salivarius24SMB administered by nasal spray for the prevention of acute media otitis in otitis-prone children. Eur J Microbiol Infect Dis 2015;34(4):2377-83
12. La Mantia I, Varricchio A, Ciprandi G. Bacteriotherapy with Streptococcus salivarius 24SMB associated with Streptococcus oralis89a administered as a nasal spray for preventing recurrent acute otitis media in children: a real-life clinical experience. Int J Gen Med 2017;10:171-5
13. Tarantino V, Savaia V, D’Agostino R, Silvestri M, Passali FM, Ciprandi G. Bacteriotherapy in children with recurrent upper respiratory tract infections. Eur Rev Med Pharmacol Sci 2019;23:39-43
14. Andaloro C, Santagati M, Stefani S, La Mantia I. Bacteriotherapy With Streptococcus Salivarius 24SMB and Streptococcus Oralis 89a Oral Spray for Children With Recurrent Streptococcal Pharyngotonsillitis: A Randomized Placebo-Controlled Clinical Study. Eur Arch Otorhinolaryngol 2019;276:879-87
15. Ciprandi G, Tosca MA, Fasce L. Allergic children have more numerous and severe respiratory infections than non-allergic children. Ped Allergy Immunol 2006;17:389–391
16. Bakshi SS. Revisiting recurrent acute rhinosinusitis prevention by azithromycin in children. J Allergy Clin Immunol Pract. 2017;5:1802
17. Veskitkul J, Wongkaewpothong P, Thaweethamchareon T, et al. Recurrent Acute Rhinosinusitis Prevention by Azithromycin in Children with Nonallergic Rhinitis. J Allergy Clin Immunol Pract. 2017;20175:1632-1638
18. Stefani S, Mezzatesta M, Oliveri S, Nicolosi VM, Russo G. In vitro study of dactimicin (ST 900) against methicillin-susceptible and -resistant staphylococci.Chemioterapia.1987;6:264-8




How to Cite

Tarantino V, Savaia V, D'Agostino R, Damiani V, Ciprandi G. Oral bacteriotherapy in children with recurrent respiratory infections: a real-life study. Acta Biomed [Internet]. 2020 Feb. 17 [cited 2024 Jul. 18];91(1-S):73-6. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/9230