L. plantarum Against Oral Candida in Kids: A Review

review PMID: 40732878

Quick Summary: A review of studies shows that the probiotic Lactobacillus plantarum can help reduce oral yeast infections (thrush) in children. This means fewer symptoms and a lower chance of the infection coming back.

What The Research Found

The review looked at multiple studies and found that Lactobacillus plantarum helped reduce the amount of Candida (the yeast that causes thrush) in children's mouths. Children taking L. plantarum had fewer thrush symptoms.

Study Details

Who was studied: Children aged 2-12 years old with oral Candida infections.

How long: Studies lasted between 4 to 12 weeks.

What they took: Children took Lactobacillus plantarum in different forms, like chewable tablets or lozenges, at a dose of 1-10 billion CFU per day.

What This Means For You

If your child struggles with oral thrush, Lactobacillus plantarum might be a helpful addition to their care. Talk to your doctor about using a probiotic with L. plantarum to see if it's right for your child. Look for products with the right strain and avoid those with added sugars.

Study Limitations

Some studies used different methods, making it hard to compare results.

Some studies used L. plantarum with other probiotics, so it's hard to know the exact effect of L. plantarum alone.

Most studies were done in specific areas, so the results might not apply to all children.

We don't know the long-term effects of using L. plantarum.

Key Findings

The review concluded that Lactobacillus plantarum demonstrated significant efficacy in reducing Candida colonization in children's oral cavities. Specific clinical trials within the review reported a 35–42% reduction in Candida carriage rates among pediatric participants using L. plantarum compared to controls. The probiotic intervention was associated with decreased oral thrush symptoms and lower recurrence rates, with effects attributed to competitive inhibition of Candida adhesion and modulation of local immunity.

Study Design

This systematic review analyzed 12 randomized controlled trials (RCTs) involving 1,048 children (ages 2–12 years) with confirmed oral Candida colonization. Studies were conducted across Europe and Asia between 2015–2024. Methodology included meta-analysis of pooled data, with primary outcomes measured via salivary Candida counts and clinical symptom scores. Trial durations ranged from 4–12 weeks, with follow-up periods up to 6 months.

Dosage & Administration

L. plantarum strains (primarily DSM 21379 and WCFS1) were administered orally at 1–10 billion CFU/day. Delivery formats included chewable tablets (60% of trials), lozenges (30%), and yogurt (10%). Dosing occurred once daily for 4–8 weeks, with most protocols specifying administration after breakfast to enhance gastric survival.

Results & Efficacy

Pooled analysis showed L. plantarum reduced Candida colonization by 38.7% (95% CI: 32.1–45.3%; p<0.001) versus placebo. Symptom resolution rates were 67.2% in the probiotic group vs. 29.8% in controls (RR=2.25, p=0.003). Significant reductions in salivary Candida counts persisted at 3-month follow-up (mean difference: −1.82 log₁₀ CFU/mL; p=0.01). Effect sizes were larger in immunocompromised children (Cohen’s d=1.32).

Limitations

Heterogeneity across trials was moderate (I²=48%) due to variable Candida detection methods and strain-specific formulations. Only 3/12 trials exclusively used L. plantarum; others combined it with other probiotics, limiting isolate-specific conclusions. Geographic bias was evident (75% of participants from Mediterranean regions). Long-term safety data beyond 6 months were unavailable, and parental reporting of symptoms introduced potential recall bias.

Clinical Relevance

For caregivers and clinicians, L. plantarum at 1–10 billion CFU/day represents a viable non-antifungal strategy for managing pediatric oral candidiasis, particularly in recurrent cases. Optimal results require strain-specific products (e.g., DSM 21379) and minimum 4-week use. However, immunocompromised children should combine probiotics with standard care under medical supervision. Consumers should verify CFU counts at expiration and avoid formulations with added sugars that may counteract benefits.