Effectiveness of Probiotic, Prebiotic, and Synbiotic Therapies in Reducing Postoperative Complications: A Systematic Review and Network Meta-analysis

Kasatpibal, Nongyao; Whitney, JoAnne D.; Saokaew, Surasak; Kengkla, Kirati; Heitkemper, Margaret; Apisarnthanarak, Anucha

doi:10.1093/cid/cix114

Cited by 61 publications

(52 citation statements)

References 39 publications

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“…Probiotics have been evaluated for preventing nosocomial infection in many smaller studies, and meta-analyses suggest that probiotics are safe and effective at preventing infection in both post-operative and mechanically ventilated patients ( 60 , 61 ). However, the small size of the individual studies, as well as the variable type and dose of probiotic therapy limit strong conclusions.…”

Section: Potential For Modulation Of the Microbiota In The Managementmentioning

confidence: 99%

Therapeutic Potential of the Gut Microbiota in the Prevention and Treatment of Sepsis

2018

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Alongside advances in understanding the pathophysiology of sepsis, there have been tremendous strides in understanding the pervasive role of the gut microbiota in systemic host resistance. In pre-clinical models, a diverse and balanced gut microbiota enhances host immunity to both enteric and systemic pathogens. Disturbance of this balance increases susceptibility to sepsis and sepsis-related organ dysfunction, while restoration of the gut microbiome is protective. Patients with sepsis have a profoundly distorted composition of the intestinal microbiota, but the impact and therapeutic potential of the microbiome is not well-established in human sepsis. Modulation of the microbiota consists of either resupplying the pool of beneficial microbes by administration of probiotics, improving the intestinal microenvironment to enhance the growth of beneficial species by dietary interventions and prebiotics, or by totally recolonizing the gut with a fecal microbiota transplantation (FMT). We propose that there are three potential opportunities to utilize these treatment modalities over the course of sepsis: to decrease sepsis incidence, to improve sepsis outcome, and to decrease late mortality after sepsis. Exploring these three avenues will provide insight into how disturbances of the microbiota can predispose to, or even perpetuate the dysregulated immune response associated with this syndrome, which in turn could be associated with improved sepsis management.

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Section: Potential For Modulation Of the Microbiota In The Managementmentioning

confidence: 99%

Therapeutic Potential of the Gut Microbiota in the Prevention and Treatment of Sepsis

2018

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“…A meta‐analysis comprising of 2952 patients who underwent either open or laparoscopic procedures showed that administering synbiotics, compared with no therapy, led to a reduction in surgical site infections (relative risk [RR] 0.28; 95%CI, 0.12‐0.64) in adult surgical patients. Those taking synbiotics also developed lower rates of pneumonia (RR 0.28; 95%CI, 0.09‐0.90), sepsis (RR 0.09; 95%CI, 0.01‐0.94) and overall hospital stay (mean = 9.66 days, 95%CI, 7.60‐11.72), but neither synbiotics nor placebo showed overall reduced mortality rates.…”

Section: Therapeutic Opportunitiesmentioning

confidence: 99%

Transplant associated infections—The role of the gastrointestinal microbiota and potential therapeutic options

et al. 2019

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Infectious complications are common following kidney transplantation and rank in the top five causes of death in patients with allograft function. Over the last 5 years, there has been emerging evidence that changes in the gastrointestinal microbiota following kidney transplantation may play a key role in the pathogenesis of transplant‐associated infections. Different factors have emerged which may disrupt the interaction between the gastrointestinal microbiota and the immune system, which may lead to infective complications in kidney transplant recipients. Over the last 5 years, there has been emerging evidence that changes in the gastrointestinal microbiota following kidney transplantation may play a key role in the pathogenesis of transplant‐associated infections. This review will discuss the structure and function of the gastrointestinal microbiota, the changes that occur in the gastrointestinal microbiota following kidney transplantation and the factors underpinning these changes, how these changes may lead to transplant‐associated infectious complications and potential treatments which may be instituted to mitigate this risk.

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“…Liu et al in another study (2015) concluded that probiotics reduced postoperative infections in patients with liver metastasis 20 . Three systematic reviews (2017) and one metaanalysis (2015) also confirmed the protective effects of probiotics and synbiotics consumption before ab-dominal surgery, which reduced infective complications such as urinary tract infections, pneumonia and sepsis 15,[20][21][22][23][24] . Liu et al recommended a diet that included bacteria of different strains, and this diet was more useful than single-strain diets for surgical infections and other infections 22 .…”

Section: Discussionmentioning

confidence: 88%

Assessment of probiotic effects on colorectal surgery complications: A double blinded, randomized clinical trial

et al. 2019

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Background: Probiotics are living bacteria, which can be used as a food supplement to produce inhibitory agents and compete with pathogens in the guts. Nowadays, because of the easy accessibility and misuse of antibiotics, probiotic usage is increasing. The goal of our study is to assess the effects of probiotics on colorectal surgery complications. Methods: The enrolled cases were selected from colorectal surgery candidate patients, who referred to Sina and Imam Reza Hospitals of Tabriz University from April of 2016 to April of 2017. They were divided into two groups of study and control. For the study group, 7 days before surgery, one capsule of probiotics (Familact) was administrated every night, while the control group was given capsules of placebo. Results: Although the infective complications, mortality ratio and duration of hospitalization in the study group were lower than the control group, these differences were not statistically significant. Discussion: Our study confirmed that preoperative probiotic consumption in colorectal surgery had not affected complications or mortality of surgery and this finding is in disagreement with some previous studies. Perhaps, other strains of bacteria or different dosage, duration and rout of administration can have positive effects on these complications. Conclusion: This study showed that there was no correlation between probiotic consumption preoperatively and decreased complications or mortality after colorectal surgery.

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Effectiveness of Probiotic, Prebiotic, and Synbiotic Therapies in Reducing Postoperative Complications: A Systematic Review and Network Meta-analysis

Cited by 61 publications

References 39 publications

Therapeutic Potential of the Gut Microbiota in the Prevention and Treatment of Sepsis

Therapeutic Potential of the Gut Microbiota in the Prevention and Treatment of Sepsis

Transplant associated infections—The role of the gastrointestinal microbiota and potential therapeutic options

Assessment of probiotic effects on colorectal surgery complications: A double blinded, randomized clinical trial

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