Probiotics for Infection Prevention in Critically Ill and Trauma Patients: A Concise Review

Abstract

BACKGROUND: Critically ill trauma patients are at an increased risk for infection, which can increase morbidity and mortality. The use of probiotic preparations for infection prevention is promising, yet the results of their effectiveness are mixed. OBJECTIVES: To synthesize current research regarding the use of probiotics to prevent and possibly treat infection in the critically ill adult trauma population. METHODS: DATA SOURCES: The medicine and nursing databases PubMed, CINAHL, and ProQuest were searched for this review. STUDY SELECTION: Studies addressed the efficacy of probiotics in the critically ill in reducing health care–associated infection rates, with particular emphasis on patients who experienced severe trauma. DATA EXTRACTION: Studies were reviewed and included through the consensus of the authors. Each study's population, design, methodology, results, and conclusions were analyzed for relevance. Of 170 publications retrieved and reviewed, 21 articles were identified for use in this review, including original research, meta-analyses, and reviews. RESULTS: DATA SYNTHESIS: There is a lack of homogeneity of studies concerning probiotic species/strain selection and frequency and timing of dosing in the current body of literature. KEY THEMES: There is also a lack of consensus on what constitutes a “health care–associated infection,” with few studies identifying specific types of infection and the role probiotics may play in preventing these infections. CONCLUSION: Upon reviewing the current body of evidence, one cannot definitively conclude that probiotic supplementation in the critically-ill trauma population decreases health care–associated infection rates and improves outcomes, but most published evidence supports their use.