#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Probio­tics in acute pancreatitis –  a randomised, placebo- controlled, double‑blind study


Authors: J. Lata 1;  J. Juránková 2;  O. Stibůrek 1;  V. Příbramská 1;  M. Šenkyřík 1;  T. Vaňásek 1
Authors place of work: Interní hepatogastroenterologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MU Dr. Jan Lata, CSc., 2Oddělení klinické mikrobio­logie FN Brno, pracoviště Bohunice, přednostka prim. MU Dr. Alena Ševčíková 1
Published in the journal: Vnitř Lék 2010; 56(2): 111-114
Category: Original Contributions

Summary

Introduction:
Infections accompanying pancreatitis, particularly pancreatic necroses, represent a serious complication associated with worsening of the disease prognosis. The aim of our study was to explore whether this complication could be prevented by administering a probio­tic.

Methods:
The probio­tic was administered to 7 patients and placebo to 15. The study was discontinued early following the release of the Propatria study results.

Results:
There was no death in our patient sample and there was no difference between the two groups in microbial colonisation or the length of hospitalization. However, a reduction in endotoxin levels on day 7 and 10 of the hospitalization was observed in the probio­tic‑treated group.

Conclusion:
Based on the current knowledge, administration of probio­tics in this indication is contraindicated. Nonetheless, reduction in endotoxin levels suggests a positive effect of probio­tics on bacterial translocation, the importance of which should be evaluated in the future.

Key words:
acute pancreatitis –  probio­tics –  endotoxin –  bacterial translocation


Zdroje

1. Bauer TM, Schwacha H, Steinbruckner B et al. Small intestinal bacterial overgrowth in human cirrhosis is associated with sy­stemic endotoxemia. Am J Gastroenterol 2002; 97: 2364– 2370.

2. Timmerman HM, Koning CJM, Mulder Let al. Monostrain, multistrain and multispecies probio­tics. A comparison of functionality and efficacy. Int J Food Microbio­l 2004; 96: 219– 233.

3. Neoptolemos JP, Rarety M, Finch M et al. Acute pancreatitis: the substantial human and financial costs. Gut 1998; 42: 886– 891.

4. Baron TH, Morgan DE. Acute necrotizing pancreatitis. N Engl J Med 1999; 340: 1412– 1417.

5. Isenmann R. Prophylactic antibio­tik treatment in patients with predicted severe acute pankreatitis: a placebo‑ controlled, double‑blind trial. Gastroenterology 2004; 126: 997– 1004.

6. Mazaki T, Ishii Y, Takayama T. Meta‑analysis of prophylactic antibio­tic use in acute necrotizing pancreatitis. Br J Surg 2006; 93: 674– 678.

7. Špičák J, Hejtmánková S, Hubaczová Met al. Antibio­tická profylaxe infekčních komplikací u akutní pankreatitidy –  výsledky randomizované studie s meropenemem. Čes Slov Gastroent Hepatol 2003; 57: 222– 227.

8. Powell JJ, Campbell E, Johnson CD et al. Survey of antibio­tic prophylaxis in acute pancreatitis in the UK and Ireland. Br J Surg 1999; 86: 320– 328.

9. Banks BA, Freeman ML et al. Practice Guidelines in Acute Pankreatitis. Am J Gastroenterol 2006; 101: 2379– 2400.

10. UK Working Party on Acute Pankreatitis. UK guidelines for the management of acute pancreatitis. Gut 2005; 54; 1– 9.

11. Havenaar R, Ten Brink B, Huisin’t Veld JHJ. Selection of strains for probio­tic use. In: Fuller R (ed): Probio­tics: the scientific basis. London: Chapman and Hall 1992: 209– 224.

12. van Minnen LP. Acute pancreatitis –  Surgery, pathophysiology, probio­tic prophylaxis. The Netherlands: Gildeprint Druk­kerijen BV, Enschede 2006.

13. Olah A, Belagyi T, Issekutz A et al. Randomized clinical trial of specific lactobacillus and fibre supplement to early enteral nutrition in patients with acute pancreatitis. Br J Surg 2002; 89: 1103– 1107.

14. Besselink MGH, van Santvoort HC, Buskens E et al. Probio­tic prophylaxis in predicted severe acute pancreatitis: a randomised, double‑blind, placebo- controlled trial. Lancet 2008; 371: 651– 659.

Štítky
Diabetology Endocrinology Internal medicine

Článok vyšiel v časopise

Internal Medicine

Číslo 2

2010 Číslo 2
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#