Probiotic and prebiotic interventions in burn patients: A systematic review

Burn injuries represent a significant global health burden, accounting for approximately 180,000 deaths annually. Probiotic and prebiotic use may offer a safe adjunctive therapy to reduce complications and enhance recovery in burn patients. This systematic review aims to evaluate current literature on the effects of probiotics and prebiotics for key outcomes in burn patients, such as sepsis, mortality, infection, and serum IgA levels.

A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by searching PubMed, Scopus, and Medline between January 1, 2000, and January 1, 2025, with the search terms (("Probiotics" OR "Prebiotics") AND "Burns"). This review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) website (CRD420251010368). Titles, abstracts, and full texts were independently screened by two reviewers. Included studies were assigned a level of evidence per Oxford Centre for Evidence-based Medicine guidelines.

Data from 9 studies with a total of 426 patients were identified. There were no statistically significant differences between probiotic treatment and control groups for sepsis rate (p = 0.42) or mortality (p = 0.32), but there was a statistically significance decrease in the probiotic treatment group's rate of infection (p < 0.0001) and a statistically significant increase in serum IgA (p < 0.0001). One study reported significant reduction in wound area for the combined probiotic and prebiotic treatment group compared to control at day 24 (p = 0.001), while another reported shorter duration to reach 95 % wound area reduction in the probiotic treatment group compared to control, though not statistically significant (p = 0.230).

This systematic review analysed the impact of probiotics and prebiotics on key outcomes in burn injury patients to assess their potential as a cost-effective and low-risk therapeutic intervention. Integration of probiotics and prebiotics into burn care represents a promising avenue for future investigation, given their favorable safety profile and emerging evidence suggesting potential benefits in enhancing immune function, reducing infection-related complications, and improving patient outcomes.