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Low-quality evidence: probiotics = placebo in preventing infections in the elderly
Clinical Question
Do probiotics prevent infections in the elderly?
Bottom line
The existing evidence is of low quality but is likely accurate: Probiotics are no better than placebo in preventing infections in the elderly. 2a
Reference
Study design: Meta-analysis (randomized controlled trials)
Funding: Foundation
Setting: Various (meta-analysis)
Synopsis
These authors searched multiple databases, trial registries, reference lists, and gray literature to identify randomized trials of probiotics versus placebo for the prevention of infections in patients older than 65 years. Two authors independently assessed studies for inclusion, with discrepancies resolved by consensus. They didn't explicitly describe the types of infections, but the tables suggest they looked at antibiotic-associated diarrhea, Clostridium difficile diarrhea, respiratory infections, and "common infectious diseases" (otherwise undefined). Three authors independently assessed each included study's risk of bias with disagreements resolved by consensus. Ultimately, they included 15 studies with 5916 patients. The studies were generally at high risk of bias. Overall, probiotics were no more effective than placebo in preventing infections. The reported frequency of adverse events was also similar between probiotics and placebo. Since studies at high risk of bias tend to favor interventions, the conslusion that probiotics don't prevent infections is likely correct.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
Comments
Well this is interesting. Last night on the Dragon's Den, Arlene offered some budding entrepreneurs $200,000 to promote their line of probiotic infused drinks and power bars (they even had a children's line of snacks!). Too bad Arlene has wasted her money - or NOT because people still buy these things.
Good
Good poem
This outcome was from “ gray ”literature. I wonder if it would be the same for young children who take probiotics when prescribed multiple courses of antibiotics for recurrent ear infections while awaiting ENT consult.
Trop de détails concernant cette étude sont manquants, ce qui nous amène à se questionner sur sa validité et son applicabilité.
Ni pour, ni contre... peu d'études, de mauvaise qualité.
Il serait fort pertinent de faire de grandes études RC vu la fréquence des infections chez les âgés... mais qui veut mettre l'argent?
I think that the treatment of the microbiome is evolving and in its infancy.All probiotics are not equal across the board.This may well tun out to be an exciting aspect of treatment of many disease processes in the future