BackgroundThe role of oral bacterial lysates (OBLs) as adjuvant immunomodulatory therapy in pediatric asthma requires clarification. This systematic review and meta-analysis evaluates their efficacy and safety.MethodsWe searched eight databases for randomized controlled trials (RCTs) in children comparing standard asthma therapy plus OBLs versus standard therapy/placebo. Primary outcomes were clinical (wheezing/infection frequency, symptom improvement time, treatment efficacy) and lung function