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

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.

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Translational Development of Microbiome‐Based Therapeutics: Kinetics of E. coli Nissle and Engineered Strains in Humans and Nonhuman Primates

“…Studies of the human microbiome in health and disease have highlighted a potential therapeutic value of live bacteria as an approach to combat complex and intractable disease states that are associated with microbial dysbiosis or have a potential site of action in the gut . Treatment with probiotic bacteria may have potential to restore microbiome balance, and numerous studies and meta‐analyses have been conducted reviewing their effectiveness in different disease states . The quality of the clinical evidence for probiotics is variable, with mostly small and open‐label trials, the majority of which do not report data on exposure in either the active or placebo group.…”

Probióticos associados ao tratamento das doenças periodontais: revisão de literatura

“…Em termos de efeitos, os probióticos são considerados para tratamentos embasados cientificamente apenas para infecções no trato respiratório e diarreia por Clostridium difficile associada ao uso de antibióticos 51 . Já, para o uso adjunto ao tratamento da doença periodontal, paira uma série de dúvidas.…”