[Potential role for probiotics in the prevention of infectious complications during acute pancreatitis].
Acute pancreatitis has a high mortality in case of secondary infection of (peri-)pancreatic necrosis. Bacterial translocation is held responsible for the majority of these infectious complications of severe acute pancreatitis. Prophylactic strategies should therefore be directed at the three most important pathophysiological mechanisms of bacterial translocation: disturbed small-bowel motility and bacterial overgrowth, failure of the mucosal barrier function and a disturbed response of the immune system. In-vitro studies and research in experimental animals have shown that specially selected probiotics exert an effect on these mechanisms and can prevent bacterial translocation. Recently, several randomised, double-blind, placebo-controlled trials evaluating prophylactic treatment with enteral probiotics have shown good results. A Dutch multicentre trial, 'Probiotics in pancreatitis trial' (PROPATRIA), is currently underway.
van Santvoort
H C
HC
Universitair Medisch Centrum Utrecht, afd. Heelkunde, G04.228, Postbus 85.500, 3508 GA Utrecht.
Besselink
M G H
MG
van Minnen
L P
LP
Timmerman
H M
HM
Akkermans
L M A
LM
Gooszen
H G
HG
D018988:Bacterial Translocation / Q000187:drug effects; D006801:Humans; D017053:Infection Control / Q000379:methods*; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications* / Q000401:mortality; D019936:Probiotics / Q000008:administration & dosage* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic