Level 2: Mid-level evidence

Children can be at high risk of infections during hospital stays, and measures commonly used to prevent nosocomial infections (e.g., hand hygiene) are not completely effective. A randomized trial with 742 children evaluated the efficacy of Lactobacillus GG for preventing hospital-acquired infections (Pediatrics. 2010;125:e1171-1177). Children (mean age 10 years) without GI and/or respiratory tract infection upon admission were randomized to receive a fermented milk product with Lactobacillus GG (1  109 colony-forming units) vs. placebo (fermented milk alone) once daily during their hospital stay. The most common reasons for hospitalization were neurologic disorders (34.6%) and noninfectious pulmonary and immunologic disorders (19.3%). The Lactobacillus GG group had significantly lower rates of GI infections (5.1% vs. 12%, P <0.05, NNT 15) and respiratory infections (2.1% vs. 5.5%, P <0.05, NNT 30). Lactobacillus GG was also associated with reductions in vomiting episodes (4.5% vs. 9%, P <0.05, NNT 23) and diarrhea episodes (1.9% vs. 7.7%, P <0.05, NNT 18). There was no significant difference in duration of hospital stay between groups, and longer stays were associated with increased infection risk.