| 1. |
- Jeppsson, Bengt, et al.
(författare)
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Use of Probiotics as Prophylaxis for Postoperative Infections
- 2011
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 3:5, s. 604-612
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Forskningsöversikt (refereegranskat)abstract
- Postoperative bacterial infections are common despite prophylactic administration of antibiotics. The wide-spread use of antibiotics in patients has contributed to the emergence of multiresistant bacteria. A restricted use of antibiotics must be followed in most clinical situations. In surgical patients there are several reasons for an altered microbial flora in the gut in combination with an altered barrier function leading to an enhanced inflammatory response to surgery. Several experimental and clinical studies have shown that probiotics (mainly lactobacilli) may reduce the number of potentially pathogenia bacteria (PPM) and restore a deranged barrier function. It is therefore of interest to test if these abilities of probiotics can be utilized in preoperative prophylaxis. These factors may be corrected by perioperative administration of probiotics in addition to antibiotics. Fourteen randomized clinical trials have been presented in which the effect of such regimens has been tested. It seems that in patients undergoing liver transplantation or elective surgery in the upper gastrointestinal tract prophylactic administration of different probiotic strains in combination with different fibers results in a three-fold reduction in postoperative infections. In parallel there seems to be a reduction in postoperative inflammation, although that has not been studied in a systematic way. The use of similar concepts in colorectal surgery has not been successful in reducing postoperative infections. Reasons for this difference are not obvious. It may be that higher doses of probiotics with longer duration are needed to influence microbiota in the lower gastrointestinal tract or that immune function in colorectal patients may not be as important as in transplantation or surgery in the upper gastrointestinal tract. The favorable results for the use of prophylactic probiotics in some settings warrant further controlled studies to elucidate potential mechanisms, impact on gut microbiota and influence on clinical management. The use of probiotics must be better delineated in relation to type of bacteria, dose and length of administration.
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| 2. |
- Thorlacius, Henrik, et al.
(författare)
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Anti-infective effects o Lactobacilli in the gastrointestinal tract
- 2003
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Ingår i: Current Medicinal Chemistry - Anti-Infective Agents. - 1568-0126. ; 2:4, s. 263-267
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Forskningsöversikt (refereegranskat)abstract
- Antibiotics constitute the dominant treatment of gastrointestinal infections. However, several serious side-effects are associated with extensive use of antibiotics, including spread of bacterial resistance and allergic reactions as well as potential overgrowth of pathogenic bacteria and viruses. On the other hand, there is a growing body of evidence suggesting that certain bacteria, referred to as probiotics, have anti-bacterial properties and may counteract the development of infections. Probiotics are defined as viable non-pathogenic microorganisms, which, upon ingestion exert a positive impact in the host. This review will focus on the antiinfective mechanisms and effects of lactobacilli and suggests that administration of lactobacilli may be an effective approach to prevent and treat a vast spectrum of infections of enteric origin.
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