Probiotics and respiratory care: the healthcare benefits

The Socio-Economic Assessment (SEA) by IPA Europe uncovers the cost savings and public health potential of increased probiotic use across seven widespread health conditions in the EU.
Focusing on respiratory tract infections (RTIs), the analysis leverages robust scientific literature and cost-of-illness studies, applying both quantitative and qualitative methods in alignment with EU Better Regulation guidelines (European Commission, 2023) and the OECD’s System of Health Accounts (OECD, 2011).

Understanding the burden of RTIs in Europe

Respiratory tract infections continue to represent a significant challenge across Europe. The common cold is a universal adversary: adults face averaging 2 to 3 episodes each year, while children, due to maturing immune systems and high social exposure, experience five to 5–8 infections per year.

Seasonal influenza intensifies this burden, affecting up to 20% of the European population annually. The greatest risk falls on vulnerable groups: those aged 65 and above face a twenty-fold increase in influenza-related mortality compared to younger populations.

Community-acquired pneumonia (CAP) further amplifies the healthcare load, with an incidence of 14 per 1,000 adults annually. The healthcare impact is substantial, as approximately 50% of these cases require hospitalization. Globally, CAP remains a significant public health challenge, accounting for an average of 23 deaths per 100,000 individuals each year.

Antimicrobial resistance in pneumonia

Compounding this immense baseline prevalence is the escalating threat of antimicrobial resistance (AMR) in pneumonia. Hypervirulent strains of Klebsiella pneumoniae (hvKp) are increasingly spreading in Europe, infecting even healthy individuals and demonstrating alarming resistance to “last-resort” carbapenem antibiotics. Yet, extensive research shows that probiotics can significantly mitigate these threats by reducing the incidence, duration and severity of respiratory infections.

Specific probiotic strains enhance mucosal immunity, reduce viral replication during influenza and inhibit the growth of dangerous pathogens like hvKp and Pseudomonas aeruginosa.
When evaluated alongside antibiotics for pneumonia, probiotics have been proven to shorten fever duration by approximately one day and reduce antibiotic-associated bowel disorders, such as diarrhea.

The economic impact of probiotics

For businesses and employers, RTIs are a leading cause of absenteeism and lost productivity at work. The combined direct and indirect economic costs of RTIs in the EU are staggering, estimated between €118 billion and €406 billion annually.

Even modest improvements associated with respiratory health management could translate into substantial economic value. Just a 1% improvement in respiratory health associated with increased probiotic use could yield direct and indirect annual economic benefits of €1.2 billion to €4.1 billion. These savings arise from lower healthcare demand, fewer days of sick leave, and a more productive workforce.

A call to action for EU policymakers

Despite scientific and economic evidence supporting the efficacy of probiotics remains blocked by regulatory barriers.

By articulating the health and economic implications of current regulations and the potential value of reform, this SEA aims to inform EU policymakers and stakeholders on the importance of addressing regulatory inconsistencies.

Reforming this landscape is crucial for public health, innovation, and competitiveness within the European probiotic sector.

Embracing a wider role for probiotics in public health strategies will relieve pressure on healthcare systems, protect the European workforce’s productivity, and contribute to ongoing discussions around innovative approaches in respiratory health and AMR.

A visual summary of the key insights