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Probiotics as Prophylaxis for Postoperative Infections of Under-five Children Following Gastrointestinal Surgery
Sheikh Mohammad Sabbir Enayet1, Kaniz Hasina2, Abdul Hanif Tablu2
1Department of Pediatric Surgery and Pediatric Urology, Evercare Hospital Dhaka, Dhaka, Bangladesh.
Insights
Probiotics did not significantly reduce postoperative wound infections in children undergoing gastrointestinal surgery. While C-reactive protein levels were lower, overall benefits for infection prophylaxis were not demonstrated in this study.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Infectious Disease Prevention
Background:
- Postoperative wound infections are a significant concern in pediatric gastrointestinal surgery.
- Probiotics are explored for their potential to modulate gut microbiota and reduce infection risk.
Purpose of the Study:
- To evaluate the efficacy of probiotics as a prophylactic measure against postoperative wound infections in children under five undergoing gastrointestinal surgery.
- To compare infection rates and inflammatory markers between children receiving probiotics and those receiving standard care.
Main Methods:
- A randomized controlled trial involving 60 pediatric patients (under 5 years) undergoing gastrointestinal surgery.
- Patients were assigned to either a probiotics group (pre- and postoperative) or a non-probiotics group.
- Outcomes measured included surgical site infection, fever, C-reactive protein (CRP), and white blood cell (WBC) counts.
Main Results:
- Postoperative wound infection occurred in 2 patients in the probiotic group versus 3 in the non-probiotic group (not statistically significant).
- Significantly lower postoperative C-reactive protein (CRP) levels were observed in the probiotic group (P=0.020).
- A greater decline in total white blood cell (WBC) count was noted postoperatively in the probiotic group, though differences in fever and neutrophil counts were not significant.
Conclusions:
- Probiotics, when used alongside traditional gut preparation, did not provide a statistically significant added benefit in preventing postoperative wound infections in pediatric gastrointestinal surgery.
- While some inflammatory markers like CRP showed improvement, the overall prophylactic efficacy for infection was not established.
Purpose:
Evaluation of the efficacy of use of probiotics as prophylaxis for postoperative wound infection in under-five children following gastrointestinal surgery.
Materials And Methods:
This randomized control trial was conducted over a period of 2 years in the pediatric surgery units of a tertiary level hospital in Dhaka, Bangladesh. A total of 60 patients undergoing gastrointestinal surgery under the age of 5 years were included in the study and randomly assigned to two groups - probiotics group (n = 30) and nonprobiotics group (n = 30). Patients in the probiotics group received probiotics in the preoperative (3 days) and postoperative period (7 days) along with traditional gut preparation (antibiotics and mechanical bowel wash). Patients in the nonprobiotic group got only antibiotics and traditional gut preparation. Outcome variables were surgical site infection, fever, c-reactive protein (CRP), total white blood cell (WBC) count, and neutrophil count.
Results:
Postoperative wound infection was less in the probiotic group (n = 2) compared to the nonprobiotic group (n = 3), but the difference was not statistically significant (P = 0.640). Postoperative CRP level was significantly lower in the probiotics group (P = 0.020). There was more decline in total count of WBCs in postoperative period in the probiotic group. No statistical difference was seen between the groups in postoperative pyrexia, the total count of WBC, and neutrophil count.
Conclusion:
Use of probiotics along with traditional gut preparation as prophylaxis for postoperative infection in children showed no added benefit in comparison to the use of traditional gut preparation only.
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