Skip to main content
Top
Published in: Current Gastroenterology Reports 7/2014

01-07-2014 | Nutrition and Obesity (SA McClave, Section Editor)

Bugs or Drugs: Are Probiotics Safe for Use in the Critically Ill?

Authors: Lindsay M. Urben, Jennifer Wiedmar, Erica Boettcher, Rodrigo Cavallazzi, Robert G. Martindale, Stephen A. McClave

Published in: Current Gastroenterology Reports | Issue 7/2014

Login to get access

Abstract

Probiotics are living microorganisms which have demonstrated many benefits in prevention, mitigation, and treatment of various disease states in critically ill populations. These diseases include antibiotic-associated diarrhea, Clostridium difficile diarrhea, ventilator-associated pneumonia, clearance of vancomycin-resistant enterococci from the GI tract, pancreatitis, liver transplant, major abdominal surgery, and trauma. However, their use has been severely limited due to a variety of factors including a general naïveté within the physician community, lack of regulation, and safety concerns. This article focuses on uses for probiotics in prevention and treatment, addresses current concerns regarding their use as well as proposing a protocol for safe use of probiotics in the critically ill patient.
Literature
1.
go back to reference Boyle RJ, Robins-Browne RM, Tang MLK. Probiotic use in clinical practice: what are the risks? Am J Clin Nutr. 2006;83:1256–64.PubMed Boyle RJ, Robins-Browne RM, Tang MLK. Probiotic use in clinical practice: what are the risks? Am J Clin Nutr. 2006;83:1256–64.PubMed
4.
go back to reference Food and Agricultural Organization of the United Nations/World Health Organization. Guidelines for the evaluation of probiotics in food. Working group report 2002. Rome, Italy/Geneva/Switzerland: FAO/WHO; 2002. Food and Agricultural Organization of the United Nations/World Health Organization. Guidelines for the evaluation of probiotics in food. Working group report 2002. Rome, Italy/Geneva/Switzerland: FAO/WHO; 2002.
5.
go back to reference Martindale R, McClave S, Warren M, Desai S. Influence of the intestinal microbiota on the critically ill patient. In: Schiffrin EJ, Marteau P, Brassart P, editors. Intestinal microbiota in health and disease: modern concepts. 1st ed. Boca Raton: CRC Press; 2014. p. 293–306. Martindale R, McClave S, Warren M, Desai S. Influence of the intestinal microbiota on the critically ill patient. In: Schiffrin EJ, Marteau P, Brassart P, editors. Intestinal microbiota in health and disease: modern concepts. 1st ed. Boca Raton: CRC Press; 2014. p. 293–306.
6.
go back to reference Morrow LE, Gogineni V, Malesker MA. Probiotic, prebiotic and synbiotic use in critically ill patients. Curr Opin Crit Care. 2012;18:186–91.PubMedCrossRef Morrow LE, Gogineni V, Malesker MA. Probiotic, prebiotic and synbiotic use in critically ill patients. Curr Opin Crit Care. 2012;18:186–91.PubMedCrossRef
7.
go back to reference Isakow W, Morrow LE, Kollef MH. Probiotics for preventing and treating nosocomial infections. Chest. 2007;132:286–94.PubMedCrossRef Isakow W, Morrow LE, Kollef MH. Probiotics for preventing and treating nosocomial infections. Chest. 2007;132:286–94.PubMedCrossRef
8.
go back to reference Hempel S, Newberry SJ, Maher AR, et al. Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systemic review and meta-analysis. JAMA. 2012;307:1959–69.PubMedCrossRef Hempel S, Newberry SJ, Maher AR, et al. Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systemic review and meta-analysis. JAMA. 2012;307:1959–69.PubMedCrossRef
9.
go back to reference McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol. 2006;101:812–22.PubMedCrossRef McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol. 2006;101:812–22.PubMedCrossRef
10.
go back to reference Morrow LE, Gogineni V, Malesker MA. Probiotics in the intensive care unit. Nutr Clin Pract. 2012;27:235–41.PubMedCrossRef Morrow LE, Gogineni V, Malesker MA. Probiotics in the intensive care unit. Nutr Clin Pract. 2012;27:235–41.PubMedCrossRef
11.
go back to reference Surawicz CM. Probiotics, antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in humans. Best Pract Res Clin Gastroenterol. 2003;17:775–83.PubMedCrossRef Surawicz CM. Probiotics, antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in humans. Best Pract Res Clin Gastroenterol. 2003;17:775–83.PubMedCrossRef
12.
go back to reference Turroni F, Ventura M, Butto LF, et al. Molecular dialogue between the human gut microbiota and the host: a Lactobacillus and Bifidobacterium perspective. Cell Mol Life Sci. 2014;71:183–203.PubMedCrossRef Turroni F, Ventura M, Butto LF, et al. Molecular dialogue between the human gut microbiota and the host: a Lactobacillus and Bifidobacterium perspective. Cell Mol Life Sci. 2014;71:183–203.PubMedCrossRef
13.
go back to reference Videlock EJ, Cremonini F. Meta-analysis: probiotics in antibiotic-associated diarrhea. Aliment Pharmacol Ther. 2012;35:1355–69.PubMedCrossRef Videlock EJ, Cremonini F. Meta-analysis: probiotics in antibiotic-associated diarrhea. Aliment Pharmacol Ther. 2012;35:1355–69.PubMedCrossRef
14.
go back to reference Munoz P, Bouza E, Cuenca-Estrella M, et al. Saccharomyces cerevisiae fungemia: an emerging infectious disease. Clin Infect Dis. 2005;40:1625–34.PubMedCrossRef Munoz P, Bouza E, Cuenca-Estrella M, et al. Saccharomyces cerevisiae fungemia: an emerging infectious disease. Clin Infect Dis. 2005;40:1625–34.PubMedCrossRef
15.
go back to reference Bouza E. Consequences of clostridium difficile infection: understanding the healthcare burden. Clin Microbiol Infect. 2012;18 Suppl 6:5–12.PubMedCrossRef Bouza E. Consequences of clostridium difficile infection: understanding the healthcare burden. Clin Microbiol Infect. 2012;18 Suppl 6:5–12.PubMedCrossRef
16.
go back to reference Safdar N, Maki DG. The commonality of risk factors for nosocomial colonization and infection with antimicrobial-resistant Staphylococcus aureus, enterococcus, gram-negative bacilli, Clostridium difficile, and Candida. Ann Intern Med. 2002;136(11):834–44.PubMedCrossRef Safdar N, Maki DG. The commonality of risk factors for nosocomial colonization and infection with antimicrobial-resistant Staphylococcus aureus, enterococcus, gram-negative bacilli, Clostridium difficile, and Candida. Ann Intern Med. 2002;136(11):834–44.PubMedCrossRef
17.
go back to reference Parkes GC, Sanderson JD, Whelan K. The mechanisms and efficacy of probiotics in the prevention of Clostridium difficile-associated diarrhea. Lancet Infect Dis. 2009;9:237–44.PubMedCrossRef Parkes GC, Sanderson JD, Whelan K. The mechanisms and efficacy of probiotics in the prevention of Clostridium difficile-associated diarrhea. Lancet Infect Dis. 2009;9:237–44.PubMedCrossRef
18.
go back to reference Dendukuri N, Costa V, McGregor M, Brophy JM. Probiotic therapy for the prevention and treatment of Clostridium difficile-associated diarrhea: a systematic review. CMAJ. 2005;173:167–70.PubMedCentralPubMedCrossRef Dendukuri N, Costa V, McGregor M, Brophy JM. Probiotic therapy for the prevention and treatment of Clostridium difficile-associated diarrhea: a systematic review. CMAJ. 2005;173:167–70.PubMedCentralPubMedCrossRef
19.
go back to reference Segarra-Newnham M. Probiotics for Clostridium difficile-associated diarrhea: focus on Lactobacillus rhamnosus GG and Saccharomyces boulardii. Ann Pharmacother. 2007;41:1212–21.PubMedCrossRef Segarra-Newnham M. Probiotics for Clostridium difficile-associated diarrhea: focus on Lactobacillus rhamnosus GG and Saccharomyces boulardii. Ann Pharmacother. 2007;41:1212–21.PubMedCrossRef
20.
go back to reference Casetagliuolo I, LaMont JT, Nikulasson ST, Pothoulakis C. Saccharomyces boulardii protease inhibits Clostridium difficile toxin A effects in the rat ileum. Infect Immun. 1996;64:5225–32. Casetagliuolo I, LaMont JT, Nikulasson ST, Pothoulakis C. Saccharomyces boulardii protease inhibits Clostridium difficile toxin A effects in the rat ileum. Infect Immun. 1996;64:5225–32.
21.
go back to reference Qamar A, Aboudola S, Warny M, et al. Saccharomyces boulardii stimulates intestinal immunoglobulin A immune response in Clostridium difficile toxin A in mice. Infect Immun. 2001;69:2762–5.PubMedCentralPubMedCrossRef Qamar A, Aboudola S, Warny M, et al. Saccharomyces boulardii stimulates intestinal immunoglobulin A immune response in Clostridium difficile toxin A in mice. Infect Immun. 2001;69:2762–5.PubMedCentralPubMedCrossRef
22.
go back to reference Tung JM, Dolovich LR, Lee CH. Prevention of Clostridium difficile infection with Saccharomyces boulardii: a systematic review. Can J Gastroenterol. 2009;23:817–21.PubMedCentralPubMed Tung JM, Dolovich LR, Lee CH. Prevention of Clostridium difficile infection with Saccharomyces boulardii: a systematic review. Can J Gastroenterol. 2009;23:817–21.PubMedCentralPubMed
23.•
go back to reference Goldenberg JZ, Ma SSY, Saxton JD, MartzenMR, Vandvik PO, Thorlund K, Guyatt GH, Johnston BC. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD006095. doi:10.1002/14651858.CD006095.pub3. Cochrane review demonstrating the safety and efficacy of the combination of Lactobacillus acidophilus and Lactobacillus casei in the prevention of CDAD in patients who are not immunocompromised. Goldenberg JZ, Ma SSY, Saxton JD, MartzenMR, Vandvik PO, Thorlund K, Guyatt GH, Johnston BC. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD006095. doi:10.​1002/​14651858.​CD006095.​pub3. Cochrane review demonstrating the safety and efficacy of the combination of Lactobacillus acidophilus and Lactobacillus casei in the prevention of CDAD in patients who are not immunocompromised.
24.
go back to reference Johnston BC, Ma SSY, Goldenberg JZ, et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea: a systematic review and meta-analysis. Ann Intern Med. 2012;157:878–88.PubMedCrossRef Johnston BC, Ma SSY, Goldenberg JZ, et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea: a systematic review and meta-analysis. Ann Intern Med. 2012;157:878–88.PubMedCrossRef
25.••
go back to reference Allen SJ, Wareham K, Wang D, et al. Lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in older patients (PLACIDE): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2013;382:1249–57. Large randomized, control trial suggesting there is no benefit when using L. acidophilus and B. bifidum in AAD and CDAD prevention, demonstrating the importance of using an appropriate strain when prescribing probiotics.PubMedCrossRef Allen SJ, Wareham K, Wang D, et al. Lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in older patients (PLACIDE): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2013;382:1249–57. Large randomized, control trial suggesting there is no benefit when using L. acidophilus and B. bifidum in AAD and CDAD prevention, demonstrating the importance of using an appropriate strain when prescribing probiotics.PubMedCrossRef
26.
go back to reference Vidal M, Forestier C, Charbonnel N, Henard S, Rabaud C, Lesens O. Probiotics and intestinal colonization by vancomycin-resistant enterococci in mice and humans. J Clin Microbiol. 2010;48:2595–8.PubMedCentralPubMedCrossRef Vidal M, Forestier C, Charbonnel N, Henard S, Rabaud C, Lesens O. Probiotics and intestinal colonization by vancomycin-resistant enterococci in mice and humans. J Clin Microbiol. 2010;48:2595–8.PubMedCentralPubMedCrossRef
27.
go back to reference Manley KJ, Fraenkel MB, Mayall BC, Power DA. Probiotic treatment of vancomycin-resistant enterococci: a randomised controlled trial. Med J Aust. 2007;186:454–7.PubMed Manley KJ, Fraenkel MB, Mayall BC, Power DA. Probiotic treatment of vancomycin-resistant enterococci: a randomised controlled trial. Med J Aust. 2007;186:454–7.PubMed
28.
go back to reference Cook D. Ventilator associated pneumonia: perspectives on the burden of illness. Intensive Care Med. 2000;26:S31–7.PubMedCrossRef Cook D. Ventilator associated pneumonia: perspectives on the burden of illness. Intensive Care Med. 2000;26:S31–7.PubMedCrossRef
29.
go back to reference Craven DE. Preventing ventilator-associated pneumonia in adults: sowing seeds of change. Chest. 2006;130:251–60.PubMedCrossRef Craven DE. Preventing ventilator-associated pneumonia in adults: sowing seeds of change. Chest. 2006;130:251–60.PubMedCrossRef
30.
go back to reference Kollef MH. Prevention of hospital-associated pneumonia and ventilator associated pneumonia. Crit Care Med. 2004;32:1396–405.PubMedCrossRef Kollef MH. Prevention of hospital-associated pneumonia and ventilator associated pneumonia. Crit Care Med. 2004;32:1396–405.PubMedCrossRef
31.
go back to reference Sachdev G, Napolitano LM. Postoperative pulmonary complications: pneumonia and acute respiratory failure. Surg Clin North Am. 2012;92:321–44. ix.PubMedCrossRef Sachdev G, Napolitano LM. Postoperative pulmonary complications: pneumonia and acute respiratory failure. Surg Clin North Am. 2012;92:321–44. ix.PubMedCrossRef
32.
go back to reference Kollef MH. What is ventilator-associated pneumonia and why is it important? Respir Care. 2005;506:714–21. Kollef MH. What is ventilator-associated pneumonia and why is it important? Respir Care. 2005;506:714–21.
33.
go back to reference Heineman J, Bubenik S, McClave S, Martindale R. Fighting fire with fire: is it time to use probiotics to manage pathogenic bacterial diseases? Curr Gastroenterol Rep. 2012;14:343–8.PubMedCrossRef Heineman J, Bubenik S, McClave S, Martindale R. Fighting fire with fire: is it time to use probiotics to manage pathogenic bacterial diseases? Curr Gastroenterol Rep. 2012;14:343–8.PubMedCrossRef
34.
go back to reference Kollef MH, Shorr A, Tabak YP, Gupta V, Liu LZ, Johannes RS. Epidemiology and outcomes of healthcare-associated pneumonia: results from a large US database of culture-positive pneumonia. Chest. 2005;128:3854–62.PubMedCrossRef Kollef MH, Shorr A, Tabak YP, Gupta V, Liu LZ, Johannes RS. Epidemiology and outcomes of healthcare-associated pneumonia: results from a large US database of culture-positive pneumonia. Chest. 2005;128:3854–62.PubMedCrossRef
35.
go back to reference Klarin B, Molin G, Jeppsson B, Larsson A. Use of the probiotic Lactobacillus plantarum 299 to reduce pathogenic bacteria in the oropharynx of intubated patients: a randomized controlled open pilot study. Crit Care. 2008;12:R136.PubMedCentralPubMedCrossRef Klarin B, Molin G, Jeppsson B, Larsson A. Use of the probiotic Lactobacillus plantarum 299 to reduce pathogenic bacteria in the oropharynx of intubated patients: a randomized controlled open pilot study. Crit Care. 2008;12:R136.PubMedCentralPubMedCrossRef
36.
go back to reference Barraud D, Blard C, Hein F, et al. Probiotics in the critically ill patient: a double blind, randomized, placebo-controlled trial. Intensive Care Med. 2010;36:1540–7.PubMedCrossRef Barraud D, Blard C, Hein F, et al. Probiotics in the critically ill patient: a double blind, randomized, placebo-controlled trial. Intensive Care Med. 2010;36:1540–7.PubMedCrossRef
37.
go back to reference Schultz MJ, Hass LE. Antibiotics or probiotics as preventative measures against ventilator-associated pneumonia: a literature review. Crit Care. 2011;15:R18.PubMedCentralPubMedCrossRef Schultz MJ, Hass LE. Antibiotics or probiotics as preventative measures against ventilator-associated pneumonia: a literature review. Crit Care. 2011;15:R18.PubMedCentralPubMedCrossRef
38.
go back to reference Morrow LE, Kollef MH, Casale TB. Probiotic prophylaxis of ventilator-associated pneumonia: a blinded, randomized, controlled trial. Am J Respir Crit Care Med. 2010;182:1058–64.PubMedCentralPubMedCrossRef Morrow LE, Kollef MH, Casale TB. Probiotic prophylaxis of ventilator-associated pneumonia: a blinded, randomized, controlled trial. Am J Respir Crit Care Med. 2010;182:1058–64.PubMedCentralPubMedCrossRef
39.
go back to reference Siempos II, Ntaidou TK, Falagas ME. Impact of the administration of probiotics on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials. Crit Care Med. 2010;38:954–62.PubMedCrossRef Siempos II, Ntaidou TK, Falagas ME. Impact of the administration of probiotics on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials. Crit Care Med. 2010;38:954–62.PubMedCrossRef
40.••
go back to reference Petrof EO, Dhaliwal R, Manzanares W, Johnstone J, Cook D, Heyland DK. Probiotics in the critically ill: a systematic review of the randomized trial evidence. Crit Care Med. 2012;40:3290–302. Meta-analysis of probiotic use in critically ill patients, demonstrated overall benefits of probiotics in reducing VAP and overall infectious complications. Heterogeneity of trials demonstrated need for more standardized assessment of the effects of probiotics to determine the true benefits.PubMedCrossRef Petrof EO, Dhaliwal R, Manzanares W, Johnstone J, Cook D, Heyland DK. Probiotics in the critically ill: a systematic review of the randomized trial evidence. Crit Care Med. 2012;40:3290–302. Meta-analysis of probiotic use in critically ill patients, demonstrated overall benefits of probiotics in reducing VAP and overall infectious complications. Heterogeneity of trials demonstrated need for more standardized assessment of the effects of probiotics to determine the true benefits.PubMedCrossRef
41.
42.
go back to reference McFarland LV, Surawicz CM, Greenberg RN, et al. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA. 1994;271:1913–8.PubMedCrossRef McFarland LV, Surawicz CM, Greenberg RN, et al. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA. 1994;271:1913–8.PubMedCrossRef
43.
go back to reference Surawicz CM, McFarland LV, Greenberg RN, et al. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin Infect Dis. 2000;31:1012–7.PubMedCrossRef Surawicz CM, McFarland LV, Greenberg RN, et al. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin Infect Dis. 2000;31:1012–7.PubMedCrossRef
44.
go back to reference Capurso G, Marignani M, Piciucchi M, Merola E, Della FG. Probiotics and severe acute pancreatitis. J Clin Gastroenterol. 2008;42:S148–51.PubMedCrossRef Capurso G, Marignani M, Piciucchi M, Merola E, Della FG. Probiotics and severe acute pancreatitis. J Clin Gastroenterol. 2008;42:S148–51.PubMedCrossRef
45.
go back to reference Oláh A, Belágyi T, Isseekutz A, et al. Randomized clinical trial of specific lactobacillus and fiber supplement to early enteral nutrition in patients with acute pancreatitis. Br J Surg. 2002;89:1103–7.PubMedCrossRef Oláh A, Belágyi T, Isseekutz A, et al. Randomized clinical trial of specific lactobacillus and fiber supplement to early enteral nutrition in patients with acute pancreatitis. Br J Surg. 2002;89:1103–7.PubMedCrossRef
46.
go back to reference Akyol S, Mas MR, Comert B, et al. The effect of antibiotic and probiotic combination therapy on secondary pancreatic infections and oxidative stress parameters in experimental acute necrotizing pancreatitis. Pancreas. 2003;26:363–7.PubMedCrossRef Akyol S, Mas MR, Comert B, et al. The effect of antibiotic and probiotic combination therapy on secondary pancreatic infections and oxidative stress parameters in experimental acute necrotizing pancreatitis. Pancreas. 2003;26:363–7.PubMedCrossRef
47.
go back to reference Muftuoglu MA, Isikgor S, Tosun S, Saglam A. Effects of probiotics on the severity of experimental acute pancreatitis. Eur J Clin Nutr. 2006;60:464–8.PubMedCrossRef Muftuoglu MA, Isikgor S, Tosun S, Saglam A. Effects of probiotics on the severity of experimental acute pancreatitis. Eur J Clin Nutr. 2006;60:464–8.PubMedCrossRef
48.
go back to reference Karaken T, Ergun M, Dogan I, et al. Comparison of early enteral nutrition in severe acute pancreatitis with prebiotic fiber supplementation versus standard enteral solution: a prospective randomized double-blind study. World J Gastroenterol. 2007;13:2733–7. Karaken T, Ergun M, Dogan I, et al. Comparison of early enteral nutrition in severe acute pancreatitis with prebiotic fiber supplementation versus standard enteral solution: a prospective randomized double-blind study. World J Gastroenterol. 2007;13:2733–7.
49.
go back to reference Oláh A, Belágyi T, Pótó L, et al. Synbiotic control of inflammation and infection in severe acute pancreatitis: a prospective, randomized, double blind study. Hepatogastroenterology. 2007;54:590–4.PubMed Oláh A, Belágyi T, Pótó L, et al. Synbiotic control of inflammation and infection in severe acute pancreatitis: a prospective, randomized, double blind study. Hepatogastroenterology. 2007;54:590–4.PubMed
50.
go back to reference Van Minnen LP, Timmerman HM, Lutgendorff F, et al. Modification of intestinal flora with multispecies probiotics reduces bacterial translocation and improves clinical course in a rat model of acute pancreatitis. Surgery. 2007;141:470–80.PubMedCrossRef Van Minnen LP, Timmerman HM, Lutgendorff F, et al. Modification of intestinal flora with multispecies probiotics reduces bacterial translocation and improves clinical course in a rat model of acute pancreatitis. Surgery. 2007;141:470–80.PubMedCrossRef
51.
go back to reference Qin HL, Zheng JJ, Tong DN, et al. Effect of Lactobacillus plantarum enteral feeding on the gut permeability and septic complications in the patients with acute pancreatitis. Eur J Clin Nutr. 2008;62:923–30.PubMedCrossRef Qin HL, Zheng JJ, Tong DN, et al. Effect of Lactobacillus plantarum enteral feeding on the gut permeability and septic complications in the patients with acute pancreatitis. Eur J Clin Nutr. 2008;62:923–30.PubMedCrossRef
52.
go back to reference Wu XG, Zhang QC. Adjuvant therapy for probiotics in patients with severe acute pancreatitis with hepatic lesion: an analysis of 27 cases. Clin Med. 2009;29:51–2. Wu XG, Zhang QC. Adjuvant therapy for probiotics in patients with severe acute pancreatitis with hepatic lesion: an analysis of 27 cases. Clin Med. 2009;29:51–2.
53.
go back to reference Sharma B, Srivastava S, Singh N, Sachdev V, Kapur S, Sarvana A. Role of probiotics on gut permeability and endotoxemia in patients with acute pancreatitis: a double-blind randomized controlled trial. J Clin Gastroenterol. 2011;45:442–8.PubMedCrossRef Sharma B, Srivastava S, Singh N, Sachdev V, Kapur S, Sarvana A. Role of probiotics on gut permeability and endotoxemia in patients with acute pancreatitis: a double-blind randomized controlled trial. J Clin Gastroenterol. 2011;45:442–8.PubMedCrossRef
55.
go back to reference Wang G, Wen J, Xu L, et al. Effect of enteral nutrition and ecoimmunonutrition on bacterial translocation and cytokine production in patients with severe acute pancreatitis. J Surg Res. 2013;183:592–7.PubMedCrossRef Wang G, Wen J, Xu L, et al. Effect of enteral nutrition and ecoimmunonutrition on bacterial translocation and cytokine production in patients with severe acute pancreatitis. J Surg Res. 2013;183:592–7.PubMedCrossRef
56.
go back to reference Besselink MGH, van Santvoort HC, Buskens E, et al. Probiotic prophylaxis in predicated severe acute pancreatitis: a randomized, double-blind, placebo-controlled trial. Lancet. 2008;371:651–9.PubMedCrossRef Besselink MGH, van Santvoort HC, Buskens E, et al. Probiotic prophylaxis in predicated severe acute pancreatitis: a randomized, double-blind, placebo-controlled trial. Lancet. 2008;371:651–9.PubMedCrossRef
57.
go back to reference Sheldon T. Dutch probiotics study is criticized for its ‘design, approval and conduct’. BMJ. 2010;340:c77.PubMedCrossRef Sheldon T. Dutch probiotics study is criticized for its ‘design, approval and conduct’. BMJ. 2010;340:c77.PubMedCrossRef
58.
go back to reference Rayes N, Hansen S, Seehofer D, et al. Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery. Nutrition. 2002;18:609–15.PubMedCrossRef Rayes N, Hansen S, Seehofer D, et al. Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery. Nutrition. 2002;18:609–15.PubMedCrossRef
59.
go back to reference Rayes N, Seehofer D, Theruvath T, et al. Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation—a randomized, double-blind trial. Am J Transplant. 2005;5:125–30.PubMedCrossRef Rayes N, Seehofer D, Theruvath T, et al. Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation—a randomized, double-blind trial. Am J Transplant. 2005;5:125–30.PubMedCrossRef
60.
go back to reference Rayes N, Seehofer D, Hansen S, et al. Early enteral supply of Lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients. Transplantation. 2002;74:123–8.PubMedCrossRef Rayes N, Seehofer D, Hansen S, et al. Early enteral supply of Lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients. Transplantation. 2002;74:123–8.PubMedCrossRef
61.
go back to reference Correia MITD, Nicoli JR. The role of probiotics in gastrointestinal surgery. Curr Opin Clin Nutr Metab Care. 2006;9:618–21.PubMedCrossRef Correia MITD, Nicoli JR. The role of probiotics in gastrointestinal surgery. Curr Opin Clin Nutr Metab Care. 2006;9:618–21.PubMedCrossRef
62.
go back to reference van Santvoort HC, Besselink MG, Timmerman HM, van Minnen LP, Akkermans LM, Gooszen HG. Probiotics in surgery. Surgery. 2008;143:1–7.PubMedCrossRef van Santvoort HC, Besselink MG, Timmerman HM, van Minnen LP, Akkermans LM, Gooszen HG. Probiotics in surgery. Surgery. 2008;143:1–7.PubMedCrossRef
63.
go back to reference Pitsouni E, Alexiou V, Saridakis V, Peppas G, Falagas ME. Does the use of probiotics/synbiotics prevent postoperative infections in patients undergoing abdominal surgery? A meta-analysis of randomized controlled trials. Eur J Clin Pharmacol. 2009;65:561–70.PubMedCrossRef Pitsouni E, Alexiou V, Saridakis V, Peppas G, Falagas ME. Does the use of probiotics/synbiotics prevent postoperative infections in patients undergoing abdominal surgery? A meta-analysis of randomized controlled trials. Eur J Clin Pharmacol. 2009;65:561–70.PubMedCrossRef
65.
go back to reference Rayes N, Seehofer D, Theruvath T, et al. Effect of enteral nutrition and synbiotics on bacterial infection rates after pylorus-preserving pancreatoduodenectomy: a randomized, double-blind trial. Ann Surg. 2007;246:36–41.PubMedCentralPubMedCrossRef Rayes N, Seehofer D, Theruvath T, et al. Effect of enteral nutrition and synbiotics on bacterial infection rates after pylorus-preserving pancreatoduodenectomy: a randomized, double-blind trial. Ann Surg. 2007;246:36–41.PubMedCentralPubMedCrossRef
66.
go back to reference McNaught CE, Woodcock NP, MacFie J, Mitchell CJ. A prospective randomised study of the probiotics Lactobacillus plantarum 299V on indices of gut barrier function in elective surgical patients. Gut. 2002;51:827–31.PubMedCentralPubMedCrossRef McNaught CE, Woodcock NP, MacFie J, Mitchell CJ. A prospective randomised study of the probiotics Lactobacillus plantarum 299V on indices of gut barrier function in elective surgical patients. Gut. 2002;51:827–31.PubMedCentralPubMedCrossRef
67.
go back to reference Kotzampassi K, Giamarellos-Bourboulis EJ, Voudouris A, Kazamias P, Eleftheriadis E. Benefits of a synbiotic formula (Synbiotic 2000Forte®) in critically ill trauma patients: early results of a randomized controlled trial. World J Surg. 2006;30:1848–55.PubMedCrossRef Kotzampassi K, Giamarellos-Bourboulis EJ, Voudouris A, Kazamias P, Eleftheriadis E. Benefits of a synbiotic formula (Synbiotic 2000Forte®) in critically ill trauma patients: early results of a randomized controlled trial. World J Surg. 2006;30:1848–55.PubMedCrossRef
68.
go back to reference Spindler-Vesel A, Bengmark S, Vovk I, Cerovic O, Kompan L. Synbiotics, prebiotics, glutamine or peptide in early enteral nutrition: a randomized study in trauma patients. JPEN J Parenter Enteral Nutr. 2007;31:119–26.PubMedCrossRef Spindler-Vesel A, Bengmark S, Vovk I, Cerovic O, Kompan L. Synbiotics, prebiotics, glutamine or peptide in early enteral nutrition: a randomized study in trauma patients. JPEN J Parenter Enteral Nutr. 2007;31:119–26.PubMedCrossRef
70.•
go back to reference Hempel S, Newberry S, Ruelaz A, Wang Z, Miles JNV, Suttorp MJ, Johnsen B, Shanman R, Slusser W, Fu N, Smith A, Roth E, Polak J, Motala A, Perry T, Shekelle PG. Safety of probiotics to reduce risk and prevent or treat disease. Evidence Report/Technology Assessment No. 200. (Prepared by the Southern California Evidence-based Practice Center under Contract No. 290-2007-10062-I.) AHRQ Publication No. 11-E007. Rockville, MD: Agency for Healthcare Research and Quality. April 2011. Available at: www.ahrq.gov/clinic/tp/probiotictp.htm. Systematic review conducted to determine the overall safety of probiotics in clinical trials. This review noted the need for more strains to be examined for efficacy in clinical trials as well as a lack of monitoring parameters used to determine efficacy and/or harm with the use of probiotics. Hempel S, Newberry S, Ruelaz A, Wang Z, Miles JNV, Suttorp MJ, Johnsen B, Shanman R, Slusser W, Fu N, Smith A, Roth E, Polak J, Motala A, Perry T, Shekelle PG. Safety of probiotics to reduce risk and prevent or treat disease. Evidence Report/Technology Assessment No. 200. (Prepared by the Southern California Evidence-based Practice Center under Contract No. 290-2007-10062-I.) AHRQ Publication No. 11-E007. Rockville, MD: Agency for Healthcare Research and Quality. April 2011. Available at: www.​ahrq.​gov/​clinic/​tp/​probiotictp.​htm. Systematic review conducted to determine the overall safety of probiotics in clinical trials. This review noted the need for more strains to be examined for efficacy in clinical trials as well as a lack of monitoring parameters used to determine efficacy and/or harm with the use of probiotics.
71.
go back to reference Mattia A, Merker R. Regulation of probiotic substances as ingredients in foods: premarket approval or “generally recognized as safe” notification. Clin Infect Dis. 2008;46:S115–8.PubMedCrossRef Mattia A, Merker R. Regulation of probiotic substances as ingredients in foods: premarket approval or “generally recognized as safe” notification. Clin Infect Dis. 2008;46:S115–8.PubMedCrossRef
72.
go back to reference Cannon JP, Lee TA, Bolanos JT, Danziger LH. Pathogenic relevance of Lactobacillus: a retrospective review of over cases. Eur J Clin Microbiol Infect Dis. 2005;24:31–40.PubMedCrossRef Cannon JP, Lee TA, Bolanos JT, Danziger LH. Pathogenic relevance of Lactobacillus: a retrospective review of over cases. Eur J Clin Microbiol Infect Dis. 2005;24:31–40.PubMedCrossRef
73.
go back to reference Enache-Angooulvant A, Hennequin C. Invasive Saccharomyces infection: a comprehensive review. Clin Infect Dis. 2005;41:1559–68.CrossRef Enache-Angooulvant A, Hennequin C. Invasive Saccharomyces infection: a comprehensive review. Clin Infect Dis. 2005;41:1559–68.CrossRef
74.
go back to reference Drago L, Mattina R, De Vecchi E, Toscano M. Phenotypic and genotypic antibiotic resistance in some probiotics proposed for medical use. Int J Antimicrob Agents. 2013;41:393–401.CrossRef Drago L, Mattina R, De Vecchi E, Toscano M. Phenotypic and genotypic antibiotic resistance in some probiotics proposed for medical use. Int J Antimicrob Agents. 2013;41:393–401.CrossRef
75.
go back to reference Courvalin P. Antibiotic resistance: the pros and cons of probiotics. Dig Liver Dis. 2006;38:S261–5.PubMedCrossRef Courvalin P. Antibiotic resistance: the pros and cons of probiotics. Dig Liver Dis. 2006;38:S261–5.PubMedCrossRef
76.
go back to reference Hennequin C, Kauffmann-Lacroix C, Jobert A, et al. Possible role of catheters in Saccharomyces boulardii fungemia. Eur J Clin Microbiol Infect Dis. 2000;19:16–20.PubMedCrossRef Hennequin C, Kauffmann-Lacroix C, Jobert A, et al. Possible role of catheters in Saccharomyces boulardii fungemia. Eur J Clin Microbiol Infect Dis. 2000;19:16–20.PubMedCrossRef
77.•
go back to reference Floch MH, Walker WA, Madsen K, et al. Recommendations for probiotic use—2011 update. J Clin Gastroenterol. 2011;45:S168–71. Guidelines compiled on the use of probiotics including which probiotics have been tested in which disease states. This was an expansion on the original guidelines which were published three years earlier.PubMedCrossRef Floch MH, Walker WA, Madsen K, et al. Recommendations for probiotic use—2011 update. J Clin Gastroenterol. 2011;45:S168–71. Guidelines compiled on the use of probiotics including which probiotics have been tested in which disease states. This was an expansion on the original guidelines which were published three years earlier.PubMedCrossRef
Metadata
Title
Bugs or Drugs: Are Probiotics Safe for Use in the Critically Ill?
Authors
Lindsay M. Urben
Jennifer Wiedmar
Erica Boettcher
Rodrigo Cavallazzi
Robert G. Martindale
Stephen A. McClave
Publication date
01-07-2014
Publisher
Springer US
Published in
Current Gastroenterology Reports / Issue 7/2014
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-014-0388-y

Other articles of this Issue 7/2014

Current Gastroenterology Reports 7/2014 Go to the issue

Inflammatory Bowel Disease (S Hanauer, Section Editor)

Managing Clostridium difficile in Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (S Hanauer, Section Editor)

Environmental Triggers for IBD

Pediatric Gastroenterology (S Orenstein, Section Editor)

Childhood Chronic Nausea: Is It Just a Queasy Stomach?

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.