American Gastroenterological Association practice guidelines for the use of probiotics

Référence

Su GL, Ko CW, Bercik P, et al. AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology 2020;159(2):697-705. Preidis GA, Weizman AV, Kashyap PC, Morgan RL. AGA Technical review on the role of probiotics in the management of gastrointestinal disorders. Gastroenterology 2020;159(2):708-738.

Sommaire

These guidelines were developed based on a systematic review of the available literature. The guideline developers focused on whether probiotics improved the outcomes patients care about. The Chair of the working group and most of the group members declared no conflicts of interest. The group also included a methodologist. The available research was evaluated for quality, and the guidelines were determined by the strength of the evidence and were to be labeled as either strong (recommended for most patients) or conditional (the benefits and risks should be discussed with patients). The group had no strong recommendations. The recommendations are appropriately conservative, given either the lack of studies or the low quality of the available research. The group gave conditional recommendations to use combination probiotics (2 or more species) for preterm, low-birth-weight infants to prevent necrotizing enterocolitis. They suggest using an 8-strain combination for adults and children with pouchitis, though this recommendation is based on very-low-quality evidence. They sugggest probiotics to prevent, but not treat, Clostridioides difficile overgrowth for people receiving antibiotic treatment. The group recommends against the use of probiotics for children with infectious gastroenteritis. Citing the lack evidence, they make no recommendation regarding the use of probiotics for patients with C. difficile infection, Crohn's disease, ulcerative colitis, or irritable bowel disease.