Probiotics Ineffective in Pancreatitis

UTRECHT, Netherlands—Patients suffering acute pancreatitis are susceptible to a 10 percent to 30 percent mortality rate largely due to infectious complications. While previous research suggested using probiotics might aid in preventing these complications by reducing bacterial overgrowth, a study published by The Lancet foundadministration of probiotics had mixed results (ePub February 14, 2008, DOI: 10.1016/S0140-6736(08)60207-X).Researchers from the University Medical Center, Utrecht, Netherlands, conducted a randomized, double blind, placebo-controlled study of severe acute pancreatitis patients (n=296), of which 152 patients were placed in the probiotics group and 144 in the placebo group. Each patient was administered a multi-species probiotic preparation or placebo, twice daily for 28 days. At the 90-day follow-up, the rate of infectious complications was 30 percent in the probiotics group vs. 41 percent in the placebo group. More patients in the probiotics group, however, died—16 percent versus 9 percent.In their conclusion, the researchers noted other combinations of strains might have resulted in different results; however, they recommended probiotics no longer be considered harmless in critically ill patients or patients at risk for non-occlusive mesenteric ischaemia.In response to the study, the International Probiotics Association (IPA) released the following statement: “The intended use ... was to use the probiotic mixed strain as a drug to reduce the number of infectious complications suggested by the study. There is very little scientific evidence of probiotics used in reducing infectious complications in patients with a disease that historically has high mortality rates. The researchers were unable to explain the cause of death, suggesting that there might be other factors that have contributed to the result. Until the cause of death is determined, the potential contribution of probiotics cannot be determined. The study in these critically ill patients fed through a tube doesn’t suggest any implications with consumption of probiotic foods, supplements and beverages where the record of safety is exemplary, especially when probiotics are used per manufacturers’ recommendations in healthy and mildly ill people. Probiotics have a long history of safe use in the general population and can be an effective way to promote good digestive health.”