Olveira Fuster G, González-Molero I
Unidad de Nutrición Clinica y Dietética, Servicio de Endocrinología y Nutriciín, Hospital Regional Universitario Carlos Haya, Málaga, Instituto de Salud Carlos III, Red RD06/001510008, España.
Nutr Hosp. 2007 May;22 Suppl 2:26-34.
This article revises the concepts of prebiotics, probiotics and symbiotics, and their use in different situations of daily clinical practice. With a high level of evidence, it is concluded that the use of certain strains of probiotics significantly reduces the risk for antibiotic-induced diarrhea. Although further studies are needed, the use of probiotics, prebiotics, and symbiotics in people suffering from inflammatory bowel disease (particularly ulcerative colitis, and pouchitis) might improve the rates of remission induction/maintenance. The administration of probiotics and symbiotics to patients with liver transplant, severe acute pancreatitis, and intensive and surgical care patients, emerges as a promising therapeutic option that seems to reduce the number of infections; however, it is currently no possible to establish evidence-based recommendations, with a need for a higher number of better designed works. About safety of probiotics and symbiotics, the benefits/risks ratio clearly favors the former since the risk for infection is low, even in immunosuppressed patients. There are, however, selected groups of patients in which caution is advised.
本文修订了益生元、益生菌和合生元的概念，以及它们在日常临床实践不同情况下的应用。基于高水平证据得出结论，使用某些益生菌菌株可显著降低抗生素相关性腹泻的风险。尽管还需要进一步研究，但在炎症性肠病（尤其是溃疡性结肠炎和袋炎）患者中使用益生菌、益生元和合生元可能会提高缓解诱导/维持率。对肝移植患者、重症急性胰腺炎患者以及重症监护和外科手术患者使用益生菌和合生元，似乎是一种有前景的治疗选择，似乎可以减少感染数量；然而，目前无法制定基于证据的建议，需要更多设计更合理的研究。关于益生菌和合生元的安全性，其效益/风险比显然有利于前者，因为即使在免疫抑制患者中，感染风险也很低。然而，有特定的患者群体建议谨慎使用。
