Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea.
Epidemiol Health. 2018;40:e2018043. doi: 10.4178/epih.e2018043. Epub 2018 Aug 29.
The 2017 guideline for the prevention of travelers' diarrhea (TD) by the International Society of Travel Medicine suggested that 'there is insufficient evidence to recommend the use of commercially available prebiotics or probiotics to prevent or treat TD.' However, a meta-analysis published in 2007 reported significant efficacy of probiotics in the prevention of TD (summary relative risk [sRR], 0.85, 95% confidence interval [CI], 0.79 to 0.91). This study aimed to synthesize the efficacy of probiotics on TD by updating the meta-analysis of double-blind, placebo-controlled, randomized human trials.
The search process was conducted by the adaptive meta-analysis method using the 'cited by' and 'similar articles' options provided by PubMed. The inclusion criteria were double-blind, placebo-controlled, randomized human trials with hypotheses of probiotics as intervention and TD as an outcome. The adaptive meta-analysis was conducted using Stata software using the csi, metan, metafunnel, and metabias options.
Eleven articles were selected for the meta-analysis. The sRR was 0.85 (95% CI, 0.79 to 0.91) and showed statistical significance. There was no heterogeneity (I-squared=28.4%) and no publication bias.
Probiotics showed statistically significant efficacy in the prevention of TD.
国际旅游医学学会 2017 年旅行者腹泻预防指南建议，“没有足够的证据推荐使用市售的益生元和益生菌来预防或治疗旅行者腹泻。”然而，2007 年发表的一项荟萃分析报告称益生菌在预防旅行者腹泻方面具有显著疗效（汇总相对风险 [sRR]，0.85，95%置信区间 [CI]，0.79 至 0.91）。本研究旨在通过更新双盲、安慰剂对照、随机人体试验的荟萃分析来综合益生菌对旅行者腹泻的疗效。
通过使用 PubMed 提供的“被引文献”和“相似文章”选项，采用适应性荟萃分析方法进行检索过程。纳入标准为双盲、安慰剂对照、随机人体试验，假设益生菌作为干预措施，旅行者腹泻作为结局。采用 Stata 软件中的 csi、metan、metafunnel 和 metabias 选项进行适应性荟萃分析。
共有 11 篇文章被纳入荟萃分析。sRR 为 0.85（95%CI，0.79 至 0.91），具有统计学意义。无异质性（I-squared=28.4%）和发表偏倚。
益生菌在预防旅行者腹泻方面具有统计学上的显著疗效。
