Loyola University Medical Center Maywood, IL, United States
Adnan Malik, MD1, Waseem Amjad, MD2, Mahum Nadeem, MD3, Khadija Naseem, MD4, Abdullah Sohail, MD5, Umer Farooq, MD6, Maryam Haider, MD7 1Loyola University Medical Center, Maywood, IL; 2Albany Medical Center, Albany, NY; 3University of Oklahoma Health Sciences Center, Oklahoma City, OK; 4West Virginia University, Charleston Division, Charleston, WV; 5West Virginia University Charleston Division, Charleston, WV; 6Loyola Medicine/MacNeal Hospital, Berwyn, IL; 7Wayne State University, Detroit Medical Center, Detroit, MI
Introduction: Severe acute pancreatitis (SAP) with major complications such as necrosis and multiple organ dysfunction syndrome (MODS) often leads to high mortality rates despite intensive treatment. This study aimed to evaluate the effect of symbiotic (probiotic) on septic complications in patients with SAP.
Methods: We searched PubMed, Cochrane CENTRAL, SCOPUS, and Web of Science for relevant clinical trials and excluded observational studies. Quality appraisal was evaluated according to GRADE and we assessed the risk of bias using Cochrane’s risk of bias tool. We included the following outcomes: C-reactive protein (CRP), APACHE Ⅱ score, hospital stay, multiorgan failure (MOF), systemic inflammatory response syndrome, Infected pancreatic necrosis, septicemia, need for operation, and death. We performed the analysis of homogeneous data under fixed-effects model, while analysis of heterogeneous data were analyzed under random-effects model. We performed the analysis of dichotomous outcomes using risk ratio (RR) and relative 95% confidence interval (CI).
Results: We included a total of seven clinical trials. We found that there was no significant difference between both groups regarding MOF (RR= 0.60 [0.25, 1.44]) (P = 0.26), septicemia (RR= 0.66 [0.29, 1.50]), (P = 0.32), death (RR= 0.66 [0.19, 2.26]), (P = 0.51), infected pancreatic necrosis (RR= 0.50 [0.18, 1.38]), (P = 0.18), and SIRS (RR = 0.81 [0.29, 2.23]), (P = 0.68),CRP,APACHE Ⅱ score, and hospital stay.
Discussion: Contrary to some published trials, our meta-analysis concludes that the use of probiotics in patients with SAP is not effective in reducing mortality rate, septic complications, and need for surgery.
Adnan Malik indicated no relevant financial relationships.
Waseem Amjad indicated no relevant financial relationships.
Mahum Nadeem indicated no relevant financial relationships.
Khadija Naseem indicated no relevant financial relationships.
Abdullah Sohail indicated no relevant financial relationships.
Umer Farooq indicated no relevant financial relationships.
Maryam Haider indicated no relevant financial relationships.
Adnan Malik, MD1, Waseem Amjad, MD2, Mahum Nadeem, MD3, Khadija Naseem, MD4, Abdullah Sohail, MD5, Umer Farooq, MD6, Maryam Haider, MD7. P0011 - The Effect of Symbiotic (Probiotic) on Septic Complications in Patients With Severe Acute Pancreatitis: A Systematic Review and Meta-Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.