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Use probiotics with caution for prevention of infection in hospitalised trauma patients

Identifying the benefits and concerns associated with different species and strains of probiotics.

Probiotics is a general term used to describe the many different species of healthy microbes that, when ingested in adequate amounts, can provide certain health benefits to the host. Probiotics have been used for centuries, mostly in the form of fermented foods such as yoghurt. They are living organisms that are usually found in our gastrointestinal tract and support our immune system.


Lactobacillus species are common probiotics. Picture: iStock

The ingestion of probiotics is thought to replenish microbiota that may have been depleted from insults such as injury, medication and diet. When there is a depletion of microbiota, pathogenic bacteria can flourish and cause disease.

Different species and strains of probiotics have different host benefits. It is important that they are consumed at regular intervals over a period of time to populate the gut.

Use and effects

Research has shown that the use of probiotics is linked to improvement in many conditions ranging from gastrointestinal irregularity and environmental allergies to prevention of secondary Candida infections. They are effective for the prevention of Clostridium difficile diarrhoea and to reduce hospital-acquired infection. Abdominal cramps, flatulence and nausea are the most commonly reported adverse effects.

Cautions

However, there have been reports of systemic infections linked to probiotic use, so they should be used with caution in people who are critically ill, immunocompromised, have structural heart disease or those who may have leakage across the bowel wall.

Although research is limited, the authors conclude that it is reasonable to use probiotics for the prevention of infection in hospital patients, but they should be used with caution and potential adverse effects must be monitored.


Vitco H, Sekula L, Schreiber M (2017) Probiotics for trauma patients: should we be taking a precautionary approach? Journal of Trauma Nursing. 24, 1, 46-52.

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