Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Streptococcus salivarius is a probiotic bacterium naturally present in the human oral cavity and upper respiratory tract. There is emerging, though still limited, scientific evidence supporting its use in the management and prevention of ear infections, particularly otitis media. Clinical research has focused primarily on specific strains such as S. salivarius K12 and M18. Several studies—including randomized controlled trials—have shown that regular administration of S. salivarius K12 may reduce the incidence of recurrent pharyngotonsillitis and, to a lesser extent, otitis media in children by colonizing the oropharynx and inhibiting pathogenic bacteria like Streptococcus pyogenes and Streptococcus pneumoniae through bacteriocin production.

However, the number of high-quality, large-scale clinical trials specifically targeting ear infections is still limited. Most available evidence comes from small studies or observational data, and the effect size appears modest. While the mechanism of competitive inhibition of pathogens and immune modulation is plausible, consensus guidelines have not yet recommended S. salivarius as a standard therapy for ear infections. Thus, while there is some scientific basis for its use—especially as a preventive measure in children prone to recurrent infections—the overall strength of evidence is moderate to low, justifying a rating of 2 out of 5.

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