An Updated Systematic Review With Meta-analysis: Efficacy of Prebiotic, Probiotic, and Synbiotic Treatment of Patients With Severe Acute Pancreatitis

Pancreas. 2021 Feb 1;50(2):160-166. doi: 10.1097/MPA.0000000000001734.

Abstract

Objectives: The aim of this study was to systematically review the clinical outcomes of all randomized controlled trials of patients with severe acute pancreatitis (SAP) and treated with pre/pro/synbiotics.

Methods: A systematic literature search of the MEDLINE, Embase, clinicaltrials.gov, and the Cochrane Central Register of Controlled Trials was conducted. Eligible studies were randomized controlled trials that evaluated the clinical outcomes of patients with SAP treated with pre/pro/synbiotics.

Results: Eleven trials comprising 930 patients were included. Patients treated with pre/pro/synbiotics had a significantly shorter hospital stay [weighted mean difference, -4.33 days; 95% confidence interval (CI), -7.71 to -0.95; P = 0.010; I2 = 66.9%] compared with control. In a subgroup analysis where only patients classified as SAP were included, those treated with pre/pro/synbiotics had lower risk of single- or multiple-organ failure (relative risk, 0.62; 95% CI, 0.44-0.88; P = 0.995; I2 = 0.0%) and decreased hospital stay (weighted mean difference, -0.65 days; 95% CI, -0.90 to -0.41; P = 0.121; I2 = 45.3%) compared with control.

Conclusions: Patients with SAP treated with pre/pro/synbiotics did not have a worse clinical outcome and had lower risk of organ failure and duration of hospital stay. Further studies should examine the optimal timing, type, and dosages of these promising treatments.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Female
  • Gastrointestinal Microbiome*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Pancreatitis / diagnosis
  • Pancreatitis / drug therapy*
  • Pancreatitis / microbiology
  • Prebiotics* / adverse effects
  • Probiotics / adverse effects
  • Probiotics / therapeutic use*
  • Risk Factors
  • Severity of Illness Index
  • Synbiotics* / adverse effects
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Prebiotics