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Prebiotics, probiotics, synbiotics in surgery--are they only trendy, truly effective or even dangerous?

Nada Rayes1, Daniel Seehofer, Peter Neuhaus

  • 1Department of General, Visceral and Transplant Surgery, Charité Campus Virchow Clinic, Augustenburger Platz 1, 13353, Berlin, Germany. nada.rayes@charite.de

Langenbeck'S Archives of Surgery
|December 17, 2008
PubMed
Abstract

Insights

Probiotics and prebiotics (synbiotics) can reduce bacterial infections after major surgery. While generally safe, their effectiveness depends on the specific preparation and therapy duration, particularly for high-risk patients.

Area of Science:

  • Surgical Infections
  • Microbiome Research
  • Gastrointestinal Health

Background:

  • Nosocomial bacterial infections are common after major abdominal surgery, increasing costs and negatively impacting outcomes.
  • Antibiotic resistance is a growing concern, necessitating alternative strategies to prevent infections.
  • Probiotics (living bacteria) and prebiotics (fibers) show potential in stabilizing the gut barrier and preventing bacterial translocation.

Purpose of the Study:

  • To review existing evidence on the use of pro- and prebiotics in surgical patients.
  • To evaluate the efficacy of synbiotics in reducing bacterial infections post-surgery.
  • To identify factors influencing the success of synbiotic therapy in surgical settings.

Main Methods:

  • A systematic search of medical databases for animal and randomized controlled trials involving pro- and prebiotics in surgical patients.
  • Primary endpoint: incidence of bacterial infections.
  • Secondary endpoints: synbiotic type/concentration, therapy duration, adverse events, and other effects.

Main Results:

  • Probiotics or synbiotics significantly reduced bacterial infection rates in 10 out of 15 clinical studies and 3 animal trials.
  • A positive trend was observed in two studies, while two showed no effect.
  • No severe adverse events were reported, except in one study with increased mortality; success varied by preparation and duration.

Conclusions:

  • Randomized controlled trials indicate a beneficial effect of synbiotics in high-risk surgical patients.
  • Synbiotic preparations demonstrated efficacy in reducing bacterial infection rates post-surgery.
  • Further extensive testing of synbiotic preparations is recommended before widespread clinical adoption.

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