Prophylactic Effect of Probiotic Streptococcus Salivarius eK12 Against Recurrent Streptococcus Pyogenes Pharyngotonsillitis Infection in Pediatrics

NCT ID: NCT06370208

Last Updated: 2026-01-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-01

Study Completion Date

2026-08-31

Brief Summary

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Recurrent Group A Streptococcus (GAS) infections, primarily presenting as strep throat, are a significant health concern in pediatric populations, leading to symptoms like sore throat, fever, and swollen lymph nodes. GAS is highly contagious and can spread easily among children in close-contact environments like schools and daycare centers, often resulting in frequent re-infections. Managing these recurrent infections typically requires antibiotics, but reliance on antibiotics carries risks, including resistance development, gut microbiota disruption, and various side effects. Probiotic therapy, particularly with Streptococcus salivarius K12, has shown promise as a preventive approach, utilizing competitive exclusion and antimicrobial production to inhibit GAS growth in the oral cavity. Recent studies have advanced this with the development of S. salivarius eK12, a re-engineered strain that enhances efficacy against GAS by preventing the survival-promoting interactions between the probiotic and pathogenic bacteria. This modified strain, now registered as Bactoblis® EVOL in Italy (EU), holds potential as an effective version to reduce the incidence and severity of GAS infections without the drawbacks of antibiotic therapy.

Detailed Description

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The primary aim of this clinical trial is to evaluate whether prophylactic use of S. salivarius eK12 can effectively reduce the frequency and severity of strep throat episodes in children. By assessing the efficacy of S. salivarius eK12 supplementation, this study seeks to provide insights into its potential as a non-antibiotic preventive strategy for recurrent strep throat infections in pediatric populations.

Conditions

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Streptococcus Pyogenes Pharyngotonsillitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Probiotic supplement group

Participants in this group will receive probiotic Streptococcus salivarius eK12 (Bactoblis® EVOLcontaining ca. 1 billion CFU of Streptococcus salivarius eK12/capsule) as daily one capsule (to be slowly dissolved in the mouth before sleeping at night time) for 3-months. There will be a further 3-months follow-up period.

Group Type EXPERIMENTAL

Probiotic Bactoblis® EVOL (Streptococcus salivarius eK12)

Intervention Type DIETARY_SUPPLEMENT

Bactoblis® EVOL: containing one billion CFU of probiotic Streptococcus salivarius eK12

Control group

Participants in this group will not receive probiotic Streptococcus salivarius eK12 (Bactoblis® EVOL).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Probiotic Bactoblis® EVOL (Streptococcus salivarius eK12)

Bactoblis® EVOL: containing one billion CFU of probiotic Streptococcus salivarius eK12

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Children aged 3-10 years.
* Recent history of documented recurrent episodes of Streptococcus pyogenes pharyngo- tonsillitis infection in the last 6 months, or 4 or more episodes in the last 12 months (S.

pyogenes infection being defined as: McIsaac score with clinical score ≥ 2 plus confirmation of S. pyogenes presence with rapid throat swab (RAD) method or McIsaac score =5.

* Willingness to comply with the study protocol and attend scheduled follow-up visits.
* Written informed consent obtained from the parent or legal guardian.

Exclusion Criteria

* Children with known allergies or hypersensitivity to probiotics or any components of the study product.
* Current use of antibiotics or within the past 30 days.
* Used oral colonizing probiotics in the last 6 months.
* Presence of severe underlying medical conditions affecting the immune system or gastrointestinal tract.
* Participation in other clinical trials involving investigational drugs or interventions.
* Inability to adhere to the study requirements due to logistical or social reasons.
* History of rheumatic disorders, bronchospasm, severe asthma, or allergy requiring corticosteroids.
* Past tonsillectomy or an indication for adeno-tonsillectomy; or severe respiratory or systemic disorders
* Individuals immunocompromised or had a condition favouring recurrent Acute Otitis Media (AOM), including severe atopy, acquired or congenital immunodeficiency, cleft palate, craniofacial abnormalities, obstructive adenoids, a chronically ruptured eardrum, sleep apnoea, or tympanostomy tubes
* Children undergoing current pharmacological therapies to prevent recurrent respiratory infections.
* Any other medical condition or circumstance that, in the investigator's judgment, would compromise the safety of the participant or the integrity of the study.
Minimum Eligible Age

3 Years

Maximum Eligible Age

10 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Università degli Studi dell'Insubria

OTHER

Sponsor Role collaborator

Liaquat University of Medical & Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Dr. Amjad Khan

Professor of Clinical Biochemistry and Experimental Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Liaquat University of Medical and Health Sciences

Jamshoro, , Pakistan

Site Status RECRUITING

Countries

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Pakistan

Facility Contacts

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Dr. Ikram Ujjan, MBBS, PhD

Role: primary

03000506955

References

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Di Pierro F, Colombo M, Zanvit A, Risso P, Rottoli AS. Use of Streptococcus salivarius K12 in the prevention of streptococcal and viral pharyngotonsillitis in children. Drug Healthc Patient Saf. 2014 Feb 13;6:15-20. doi: 10.2147/DHPS.S59665. eCollection 2014.

Reference Type RESULT
PMID: 24600248 (View on PubMed)

Di Pierro F, Veeraraghavan G, Kalaiselvan K, Ashif B, Jeyakumar L, Gopalakrishnan G, Cazzaniga M, Bertuccioli A, Tanda ML, Zerbinati N, Ujjan I, Bugti AA, Bano A, Gull Y, Mumtaz N, Khan A. In Vitro and In Vivo Safety Evaluation of Streptococcus salivarius eK12, a Genetically Modified Dietary Probiotic Derived from the Oral Probiotic S. salivarius K12. J Microbiol Biotechnol. 2025 Dec 9;35:e2509016. doi: 10.4014/jmb.2509.09016.

Reference Type BACKGROUND
PMID: 41391486 (View on PubMed)

Di Pierro F, Bugti AA, Bano A, Kara M, Ujjan I, Mumtaz N, Gull Y, Cazzaniga M, Bertuccioli A, Tanda ML, Zerbinati N, Hameed S, Khan A. Study to evaluate the safety and tolerability of Streptococcus salivarius eK12, a genetically modified strain derived from the oral probiotic S. salivarius K12: Results from a randomized, double-blind, placebo-controlled, parallel-group clinical trial. Front Nutr. 2025 Dec 8;12:1701611. doi: 10.3389/fnut.2025.1701611. eCollection 2025.

Reference Type BACKGROUND
PMID: 41438195 (View on PubMed)

Di Pierro F, Colombo M, Giuliani MG, Danza ML, Basile I, Bollani T, Conti AM, Zanvit A, Rottoli AS. Effect of administration of Streptococcus salivarius K12 on the occurrence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media in 3 years old children. Eur Rev Med Pharmacol Sci. 2016 Nov;20(21):4601-4606.

Reference Type RESULT
PMID: 27874935 (View on PubMed)

Di Pierro F, Colombo M, Zanvit A, Rottoli AS. Positive clinical outcomes derived from using Streptococcus salivarius K12 to prevent streptococcal pharyngotonsillitis in children: a pilot investigation. Drug Healthc Patient Saf. 2016 Nov 21;8:77-81. doi: 10.2147/DHPS.S117214. eCollection 2016.

Reference Type RESULT
PMID: 27920580 (View on PubMed)

Di Pierro F, Donato G, Fomia F, Adami T, Careddu D, Cassandro C, Albera R. Preliminary pediatric clinical evaluation of the oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes and recurrent acute otitis media. Int J Gen Med. 2012;5:991-7. doi: 10.2147/IJGM.S38859. Epub 2012 Nov 30.

Reference Type RESULT
PMID: 23233809 (View on PubMed)

Related Links

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Other Identifiers

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LUMHS/REC/-496/11.11.2024

Identifier Type: -

Identifier Source: org_study_id

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