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A new clinical study has revealed the combination of strains Lactiplantibacillus plantarum KABP® -033, Lactiplantibacillus plantarum KABP® -022, Lactiplantibacillus plantarum KABP® -023 and Pediococcus acidilactici KABP® -021, can reduce symptom duration in children with upper respiratory tract infections (URIs) with pharyngitis of diverse viral origin.[i] Consistent with prior research and supporting cross-age and broad spectrum efficacy these findings build upon a previous randomized controlled trial with AB21®, where symptom duration was reduced in adults with respiratory discomfort.[ii]
In the new randomized, double-blind, placebo-controlled trial to evaluate the efficacy of the AB21® probiotic during an ongoing viral infection, 75 children aged 6 months to 5 years with clinically diagnosed viral URIs received L. plantarum KABP® -033, L. plantarum KABP® -022, L. plantarum KABP® -023 and P. acidilactici KABP® -021 (2x109 CFU) or placebo twice daily for 15 days. The children were then monitored at follow-up assessments 15 and 45 days after completing the intervention. Results showed that probiotic intervention with the AB21® blend shortened the duration of fever by 1.1 days, a 40% reduction, and pain/discomfort by 0.7 days, a 19% reduction, compared to placebo.
Notably, this is one of the few pediatric probiotic studies that verified which viruses caused the symptoms, and used both clinical and molecular confirmation, thereby ensuring high reliability and diagnostic robustness. The children included in this study had URIs diagnosed by pediatricians using clear clinical criteria (pharyngitis accompanied by fever), and causative agents were determined by PCR analysis of nasopharyngeal swabs. Previous trials of probiotics for pediatric URIs have mostly relied on parent/caregiver diagnosis, which can be subjective.[iii],[iv]
Secondary outcomes investigated by the study revealed that, during the intervention phase, body temperature and FLACC (Face, Legs, Activity, Cry and Consolability) scores were significantly lower in the probiotic group versus placebo. Moreover, 15 days after completing the intervention, incidence of nasal congestion and total number of symptoms were significantly lower in children who had received AB21®, suggesting that immune-stimulating effects were seemingly maintained for some time following supplementation. 1
“URIs in children are a significant global health concern,” comments Jordi Espadaler, Director of Innovation at AB-BIOTICS. “Due to their developing immune systems, children under 5 years old are a high-risk group, with more cases and serious or fatal outcomes reported yearly than for any other age group.[v] This study expands the evidence that AB21® can positively impact viral respiratory infections through its unique mechanism of action, activating the immune system via its effect on immunity cells[vi],[vii] as well as enhancing the gut barrier function,[viii],[ix] and reducing local inflammation.[x] Together, the local and systemic effects of AB21® help to accelerate viral clearance, speeding recovery and promoting protection from future infections.”
Although the study allowed use of common over-the-counter medications such as ibuprofen to relieve symptoms, use of these rescue treatments was comparable between the two groups. This confirms the potential for AB21® to be used as a safe and effective adjunct to improve the standard care for pediatric viral URIs, and demonstrates how selected probiotics strains have a fundamental role to play in creating breakthrough health solutions that improve lives worldwide.
To learn more about AB21®, its mechanism of action and research behind this unique blend in children and adults with viral respiratory infections, visit: Probiotics for Immune health — AB-BIOTICS
Read the full study here: A probiotic containing L. plantarum and P. acidilactici strains for treating upper respiratory infection in children aged 6 months to 5 years: a randomized, double-blind trial | European Journal of Pediatrics
[i] Andrade-Platas, D., Martinez-Figueroa, M.G., Rodriguez-Palmero, M. et al. A probiotic containing L. plantarum and P. acidilactici strains for treating upper respiratory infection in children aged 6 months to 5 years: a randomized, double-blind trial. Eur J Pediatr 184, 795 (2025). https://doi.org/10.1007/s00431-025-06587-7
[ii] Gutiérrez-Castrellón, P. et al. (2022). Probiotic improves symptomatic and viral clearance in Covid19 outpatients: a randomized, quadruple-blinded, placebo-controlled trial. Gut Microbes, 14(1), 2018899.
[iii] King S, et al. (2014). Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis. British Journal of Nutrition, 112(1), 41-54.
4 Zhao Y, et al. (2022). Probiotics for preventing acute upper respiratory tract infections. Cochrane database of systematic reviews, (8).
[v] Zhang, SX, et al. (2024). Global, regional, and national burden of upper respiratory infections, 1990–2021: Findings from the Global Burden of Disease study 2021. Science in One Health, 3, 100084.
[vi] Altadill, T., et al. (2024). Abstract 1263 Probiotic blend of L. plantarum and P. acidilactici (AB21) stimulates type-I interferon response in phagocytes with the participation of the IRF7 transcription factor, possibly involving both MyD88-dependent and independent mechanisms. Journal of Biological Chemistry, 300(3).
[vii] Kaneka Probiotics. ASBMB Congress poster, April 2024.
[viii] Pérez, M, et al. (2020). Derived postbiotics of a multi‐strain probiotic formula clinically validated for the treatment of irritable bowel syndrome. The FASEB Journal, 34(S1), 1-1.
[ix] Segawa, S., et al. (2011). Probiotic-derived polyphosphate enhances the epithelial barrier function and maintains intestinal homeostasis through integrin–p38 MAPK pathway. PloS one, 6(8), e23278.
[x] Chong, H. X., et al. (2019). Lactobacillus plantarum DR7 alleviates stress and anxiety in adults: a randomised, double-blind, placebo-controlled study. Beneficial microbes, 10(4), 355-374.