Department of Medicinal Chemistry, School of Pharmacy, University of Washington, Seattle, WA, 98195, USA.
Department of Biological and Environmental Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, United Kingdom.
Travel Med Infect Dis. 2019 Jan-Feb;27:11-19. doi: 10.1016/j.tmaid.2018.09.007. Epub 2018 Sep 29.
Travellers' diarrhea (TD) impacts annually over 20 million tourists, business travellers and military troops on a worldwide basis. Reliance on antibiotic prophylaxis and educational programs has not lead to a significant reduction in TD rates. Previous reviews of probiotics for TD have not accounted for the strain-specificity of probiotic efficacy nor have investigated prebiotics for the prevention of TD.
Standard literature databases were searched from 1977 to June 2018 unrestricted by language. Inclusion criteria included: Probiotic, probiotic or symbiotic interventions, randomized, controlled clinical trials (RCTs) and ≥2 RCTs with the same probiotic strain or mixture.
Of 158 screened articles, 12 RCT were included in the systematic review and 6 RCTs (with nine treatment different arms) were included in the meta-analysis. Saccharomyces boulardii CNCM I-745 showed a significant reduction in TD incidence (RR = 0.79, 95% C.I. 0.72-0.87, p < 0.001), while L. rhamnosus GG showed a trend (p = 0.08) and L. acidophilus showed no significant (p = 0.16) reduction of TD.
The number of trials using probiotics or prebiotics for the prevention of TD continues to be limited in number. Only one of three probiotics showed significant efficacy for the prevention of TD. More research is needed for other probiotics strains and prebiotics to determine if they could also prevent TD.
旅行者腹泻（TD）每年影响全球超过 2000 万的游客、商务旅行者和军队。对抗生素预防和教育计划的依赖并没有导致 TD 发病率的显著降低。之前对益生菌治疗 TD 的综述没有考虑到益生菌功效的菌株特异性，也没有调查过用于预防 TD 的益生元。
从 1977 年至 2018 年 6 月，不受语言限制，对标准文献数据库进行了搜索。纳入标准包括：益生菌、益生菌或共生体干预、随机对照临床试验（RCT）以及具有相同益生菌株或混合物的≥2 项 RCT。
在 158 篇筛选文章中，有 12 项 RCT 被纳入系统评价，6 项 RCT（有 9 个不同的治疗组）被纳入荟萃分析。布拉氏酵母菌 CNCM I-745 显示出对 TD 发病率的显著降低（RR=0.79，95%CI 0.72-0.87，p<0.001），而鼠李糖乳杆菌 GG 显示出趋势（p=0.08），嗜酸乳杆菌则没有（p=0.16）显著降低 TD。
用于预防 TD 的益生菌或益生元试验的数量继续受到限制。三种益生菌中只有一种对预防 TD 有效。需要对其他益生菌菌株和益生元进行更多研究，以确定它们是否也能预防 TD。
