Lactobacillus rhamnosus GG (LGG) for Atopic Dermatitis
Verdict: Published with Warning
Across 6 PubMed studies, the evidence for Lactobacillus rhamnosus GG (LGG) in Atopic Dermatitis grades Tier C — weak evidence. Effective, but with safety or population caveats.
C 🟠 C Weak Evidence Published with Warning
Why this grade7-layer evidence engine
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Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditableRaw score 0.47
D
C
B
A
S
← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
C · Published with Warning
Confidence
71%
Broadly consistent
Evidence level
E1
Cochrane high-quality SR/MA
▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.468
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 positive (2 篇 > 1 negative)
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
PubMed studies (6)L2 · primary research & systematic reviews
Probiotics for treating eczema (Cochrane Database of Systematic Reviews)
Finding: Across 39 RCTs (n=2599), probiotics made little or no difference to patient-rated symptoms (MD -0.44, 95% CI -1.22 to 0.33; moderate-certainty) and reduced SCORAD by only 3.91 points (95% CI -5.86 to -1.96; low-certainty), below the ~8.7-point clinically important threshold.
View on PubMed Lactobacillus rhamnosus GG in the Primary Prevention of Eczema in Children: A Systematic Review and Meta-Analysis (Nutrients)
Finding: Pooling 5 RCTs (7 publications, n=889), the authors concluded LGG was ineffective in reducing eczema and the data do not support using probiotics for eczema prevention (high-to-moderate certainty).
View on PubMed Comparative effectiveness of probiotic strains for the treatment of pediatric atopic dermatitis: A systematic review and network meta-analysis (Pediatric Allergy and Immunology)
Finding: In a network meta-analysis of 22 studies/28 strains, Lactobacillus rhamnosus GG was NOT among the effective strains (top performers were Mix1, L. casei DN-114001, Mix6) and ranked lowest on the safety profile.
View on PubMed Single-Strain Probiotic Lactobacilli for the Treatment of Atopic Dermatitis in Children: A Systematic Review and Meta-Analysis (Pharmaceutics)
Finding: Across 14 pooled RCTs (n=1124), single-strain lactobacilli reduced SCORAD overall (MD -4.50, 95% CI -7.50 to -1.49; p=0.003), but L. rhamnosus was significantly LESS effective than L. fermentum and no separate significant effect for LGG was demonstrated.
View on PubMed Lactobacillus rhamnosus Used in the Perinatal Period for the Prevention of Atopic Dermatitis in Infants: A Systematic Review and Meta-Analysis (American Journal of Clinical Dermatology)
Finding: Pooling 11 RCTs, perinatal L. rhamnosus reduced atopic eczema at <=2 years (RR 0.60, 95% CI 0.47-0.75; p<0.00001) and 6-7 years (RR 0.62, 95% CI 0.50-0.75), though effects at 4-5 and 10-11 years were not significant.
View on PubMed Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial (Lancet) [Kalliomaki et al.]
Finding: In this landmark double-blind RCT (159 randomised, 132 analysed at 2 yr), atopic eczema occurred in 15/64 (23%) of the LGG group vs 31/68 (46%) of placebo (RR 0.51, 95% CI 0.32-0.84), halving incidence.
View on PubMed Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …
L4a US FDA
Supportive
GRN No. 231 — Notified Substance: Lactobacillus casei subsp. rhamnosus strain GG. Intended Use: Ingredient in term infant formula, at levels not to exceed 10^8 colony forming units per gram of powdered formula. Notifier: Mead Johnson & Company. Agency Response: FDA has no questions (closure date: May 29, 2008). source↗
L4b EU EFSA
Cautious
The bacterial species L. rhamnosus (now Lacticaseibacillus rhamnosus) is considered by EFSA to be suitable for the qualified presumption of safety (QPS) approach to safety assessment. However, the EFSA Panel on Dietetic Products, Nutrition and Allergies concluded that a cause and effect relationship has not been established between the consumption of Lactobacillus rhamnosus GG (ATCC 53103, LGG)… source↗
L4c UK NHS
Neutral
Probiotics are generally classed as food rather than medicine, which means they don't go through the rigorous testing medicines do. ... For most people, probiotics appear to be safe. If you want to try them, and you have a healthy immune system, they shouldn't cause any unpleasant side effects. ... If you have an existing health condition or a weakened immune system, you should talk to a doctor… source↗
L4d TW TFDA / 衛福部
Supportive
Lactobacillus rhamnosus is listed in the 'Food Ingredients Available for Use' (可供食品使用原料) comprehensive list as a lactic acid bacterium (乳酸菌), in the form of bacterial cells (菌體), and can be used as a food ingredient or for food processing purposes. source↗
L4e WHO
Supportive
Administration of Lacticaseibacillus rhamnosus GG (LGG) to children with gastroenteritis is recommended by universal guidelines. The World Gastroenterology Organisation's Global Guidelines for Probiotics and Prebiotics (2023 update) lists LGG as having documented, positive results in multiple gut-related health areas. The FAO/WHO Joint Working Group (London, Ontario, 2002) 'Guidelines for the E… source↗
L5a NIH Office of Dietary Supplements
Supportive
Lactobacillus rhamnosus GG is an example where Lactobacillus is the genus, rhamnosus is the species, and GG is the strain. Treatment with LGG compared with placebo or no additional treatment reduced the risk of antibiotic-associated diarrhea in patients treated with antibiotics from 22.4% to 12.3% (relative risk: 0.49). However, when children and adults were evaluated separately, the difference… source↗
L5b Mayo Clinic
Supportive
Mothers who take acidophilus by mouth during pregnancy and when breastfeeding and give acidophilus to their babies and young infants might lower their babies' and children's chances of having eczema, called atopic dermatitis. It also may lessen how often the children have eczema or how severe their eczema symptoms are if they have them. source↗
L5c Cleveland Clinic
Neutral
Atopic dermatitis and acne. source↗
L5e Specialty Society (condition-mapped)
Against
Conditional recommendations are made against early food introduction, human milk consumption, and probiotic or vitamin D supplementation for AD prevention. source↗