Comment: The quality of evidence is downgraded by study limitations (lack of allocation concealment, blinding, and incomplete outcome data in half of the studies) and by imprecise results (wide confidence intervals).
A Cochrane review included 10 studies with a total of 1656 subjects. Probiotics increased the rate of short-term clinical cure and mycological cure and decreased relapse rate at one month . However, this effect did not translate into a higher frequency of long-term clinical cure or mycological cure. Probiotics use did not increase the frequency of serious adverse events (RR 0.80, 95% CI 0.22 to 2.94; 2 trials, n=440).
| Outcome | Relative risk (95% CI) | Risk - with control - Antifungal drug | Risk with intervention - Antifungal drug and probiotics (95% CI) | No of participants (studies) |
|---|---|---|---|---|
| Clinical cure rate: follow-up 5-10 days | 1.14 (1.05 to 1.24) | 721 per 1000 | 822 per 1000 (757 to 894) | 695 (5) |
| Clinical cure rate: 1 month after treatment | RR 1.07 (0.86 to 1.33) | 635 per 1000 | 679 per 1000 (546 to 845) | 172 (1) |
| Mycological cure rate: follow-up 5-10 days | RR 1.06 (1.02 to 1.10) | 880 per 1000 | 933 per 1000 (898 to 968) | 969 (7) |
| Mycological cure rate: follow-up 28-30 days | RR 1.26 (0.93 to 1.71) | 706 per 1000 | 890 per 1000 (657 to 1000) | 627 (3) |
| Mycological cure rate: 3 months | RR 1.16 (1.00 to 1.35) | 741 per 1000 | 860 per 1000 (741 to 1000) | 172 (1) |
| Relapse rate follow-up: 30-37 days after treatment | RR 0.34 (0.17 to 0.68) | 145 per 1000 | 49 per 1000 (25 to 99) | 388 (3) |
Date of latest search: 2018-02-05