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These conditions are among the primary reasons that children visit hospitals and require antibiotic treatment. This study evaluated the efficacy of the nasal-spraying probiotics (LiveSpo Navax containing 5\u00a0billion\n                    <jats:italic>Bacillus subtilis<\/jats:italic>\n                    and\n                    <jats:italic>B. clausii<\/jats:italic>\n                    spores\/5 mL) as a supportive treatment for dual ARS and AOM with otorrhea in a randomized, single-blind, controlled clinical trial. Eighty-two patients (41 per group), aged 1 month to 12 years, received standard care along with nasal spraying of either physiological saline (Control group) or LiveSpo Navax (Navax group), administered three times daily over a 7-day follow-up period. A total of sixty-one patients (30\u201331 per group) completed the trial. The Navax group experienced 68.00% and 96.77% reductions in nasal congestion (by day 3) and rhinorrhea (by day 7), respectively, which were 2.04 and 1.94-fold higher than the Control group, with odds ratios (OR) of 4.31 and 30.00 (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Endoscopic results indicated 8% and 11% higher reductions in nasal mucopurulent discharge and tympanic membrane hyperemia in the Navax group compared to the Control group. By day 3, compared to day 0, the Navax group exhibited\u2009&gt;\u20091200-fold reduction in\n                    <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                    and \u2265 4-fold reduction in\n                    <jats:italic>Haemophilus influenzae<\/jats:italic>\n                    concentrations (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05) in both nasopharyngeal and middle ear fluid samples, whereas the Control group showed no significant reductions. Navax treatment reduced IL-6 by 1.35- to 1.74-fold and TNF-\u03b1 by 1.17- to 1.45-fold, more effectively than the Control group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). These results suggest that nasal-spray\n                    <jats:italic>Bacillus<\/jats:italic>\n                    spore probiotics, with their ability to reduce bacterial load and modulate immune responses, provide a cost-effective and safe solution for alleviating symptoms of both ARS and AOM in children.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Trial registration<\/jats:italic>\n                    : ClinicalTrials.gov, Identifier NCT05804123 on April 7, 2023.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-87372-2","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T14:13:38Z","timestamp":1737987218000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Alleviating symptoms of paediatric acute rhinosinusitis and acute otitis media with otorrhea using nasal-spraying Bacillus probiotics: a randomized controlled trial"],"prefix":"10.1038","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct05804123","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Thanh Huu","family":"Khieu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dung Phuong","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binh Thanh","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binh Thanh","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Thi","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duc Minh","family":"Truong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung Minh","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh Hoa","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung Dinh","family":"Pham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh Thi","family":"Van Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"87372_CR1","first-page":"685","volume":"63","author":"T Sakulchit","year":"2017","unstructured":"Sakulchit, T. & Goldman, R. 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