Unveiling the Therapeutic Potential of Probiotics in Sepsis: A Review

Sepsis continues to be among the most significant causes of mortality and morbidity globally, as defined by an exaggerated host response to infection resulting in a peak of systemic inflammation, organ dysfunction, and unnecessary mortality. The many complexities of sepsis, such as its pathophysiology, current treatments, and its evolving place within nutrition care, are debated. The major etiologies of sepsis are bacterial, viral, and fungal infections leading to an inappropriate immune response with cytokine storm, endothelial damage, and multiorgan failure. Although there has been advancement in medical management, the current treatment approaches, like antibiotic therapy, fluid therapy, and organ support, are insufficient to decrease mortality; therefore, there is a pressing need for effective treatment. Current studies target the central position of nutrition in sepsis treatment, that is, gut microbiota in immune function and systemic inflammation. Nutritional treatment, encompassing enteral and parenteral nutrition, is designed to support metabolic homeostasis, boost immune resistance, and modulate catabolic stress in critically ill patients. The gut-sepsis axis is also emphasized, since dysbiosis and intestinal barrier dysfunction lead to systemic inflammation and aggravate sepsis outcomes. Recent evidence indicates that probiotics can provide adjunct benefits via gut microbiota manipulation, immune system augmentation, and anti-inflammatory effects. This review accentuates the requirement for integrative therapeutic strategies in the form of conventional sepsis treatment augmented by specific nutritional interventions to optimize patient survival and recovery. Follow-up studies must focus on improving individualized nutrition therapy, clarifying the role of gut microbiota in the pathogenesis of sepsis, and finding new therapeutic targets for preventing complications of sepsis.