Guidance on the use of probiotics in clinical practice in children with selected clinical conditions and in specific vulnerable groups.

_The use of probiotics has been covered by many guidelines, position papers and evidence-based recommendations, but few have referred to specific patient groups orclinical indications. This review summarises recommendations and scientifically credited guidelines on the use of probiotics for children with selected clinical conditions andprovides practice points.Methods_ An expert panel was convened by the European Paediatric Association in June 2017 to define the relevant clinical questions for using probiotics in paediatric health care and review and summarise the guidelines, recommendations, position papers and high-quality evidence.Results_ The panel found that specific probiotic strains were effective in preventing antibiotic-associated and nosocomial diarrhoea, treating acute gastroenteritis and treatinginfantile colic in breastfed infants. However, special caution is indicated for premature infants, immunocompromised and critically ill patients and those with central venouscatheters, cardiac valvular disease and short-gut syndrome. This review discusses the safety of using probiotics in selected groups of paediatric patients and the quality of the availableproducts providing practice points based on proved findings.Conclusion_ Efficacy of probiotics is strain specific. Their benefits are currently scientifically proven for their use in selected clinical conditions in children and not recommended for certain patient groups_