Using probiotics in clinical practice: Where are we now? A review of existing meta-analyses

Gut Microbes. 2017 Nov 2;8(6):521-543. doi: 10.1080/19490976.2017.1345414. Epub 2017 Jul 21.

Abstract

The scientific literature has demonstrated that probiotics have a broad spectrum of activity, although often the results are contradictory. This study provides a critical overview of the current meta-analyses that have evaluated the efficacy of probiotics in physiologic and pathological conditions, such as metabolic disease, antibiotic-associated and Clostridium difficile-associated diarrhea, IBS, constipation, IBD, chemotherapy-associated diarrhea, respiratory tract infection, ventilator-associated pneumonia, NAFLD, liver encephalopathy, periodontitis, depression, vaginosis, urinary tract infections, pancreatitis, incidence of ventilator-associated pneumonia, hospital infection and stay in ICU, mortality of post-trauma patients, necrotising enterocolitis in premature infants. Only for antibiotic- and Clostridium difficile-associated diarrhea, and respiratory tract infections the effects of probiotics are considered "evidence-based." Concerning other fields, meta-analyses lacks to define type and biologic effect of probiotic strains, as well as the outcome in a disease state. Therefore, the results presented should be a stimulus for further studies which will provide clinical recommendations.

Keywords: cardiovascular disease; diabetes; gastrointestinal disease; infections; obesity; probiotics.

Publication types

  • Review

MeSH terms

  • Clinical Studies as Topic / standards
  • Diarrhea / chemically induced
  • Diarrhea / therapy*
  • Evidence-Based Practice / standards
  • Evidence-Based Practice / trends
  • Humans
  • Meta-Analysis as Topic
  • Probiotics / therapeutic use*
  • Respiratory Tract Infections / therapy*