Does the use of probiotics/synbiotics in patients undergoing abdominal surgery prevent postoperative infections? A systematic review of randomised controlled trials

Abstract number: R2436

Pitsouni E., Alexiou V., Saridakis V., Peppas G., Falagas M.

Objective: Advanced surgical techniques and improved perioperative care have considerably lowered postoperative morbidity. However, infection following abdominal operation remains a considerable morbidity factor. Probiotics are food supplements containing, beneficial to the host, live bacteria. These bacteria inhibit the growth of pathogens and support microbial balance of the intestine towards a healthier flora. Prebiotics are indigestible sugars that stimulate the growth or activity of certain bacteria of the gastrointestinal flora, to the benefit of the host. We sought to evaluate the current literature and identify the potential benefit, if any, of perioperative administration of probiotics/synbiotics to patients undergoing abdominal surgery.

Methods: We searched PubMed, Scopus, Web of Science and Cochrane library to identify randomised controlled trials (RCTs) that studied the perioperative administration of probiotics/synbiotics in patients undergoing abdominal surgery.

Results: Eight RCTs studying 753 patients were included in our study. The incidence of postoperative infectious complications (intra abdominal abscess, wound infection, bacteraemia, cholangitis, liver abscess) were less frequent in patients receiving probiotics compared to the control group. In addition, in 1 study delayed gastric emptying was less frequent in the group receiving probiotics compared to the control group. Two studies report that septic morbidity between the group of patients receiving synbiotics and the control group did not differ significantly. Two studies report shorter length of hospital stay in the group of patients receiving symbiotics; however, 5 other studies do not report any inter-group difference regarding the length of hospitalisation.

Conclusion: The use of probiotics and/or synbiotics may have beneficial effect in the reduction of postoperative infections after abdominal surgery. However, available data do not permit the derivation of safe conclusions. RCTs focusing in specific abdominal surgery, using the same synbiotic supplement and the same therapeutic route are warranted to further evaluate this promising preventive option that may decrease morbidity, length of antibiotic therapy, hospital stay, and pressure for emergence of antimicrobial resistance.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Location: Barcelona, Spain
Presentation type:
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