title: Probiotic treatment with Probioflora in patients with predicted severe acute pancreatitis without organ failure.
abstract: BACKGROUND
  We previously demonstrated that probiotic prophylaxis, in patients with predicted severe pancreatitis, did not prevent infectious complications but unexpectedly increased the risk of bowel ischemia and mortality. The suggestion that these negative findings are only observed in the presence of organ failure at the start of probiotic treatment has not been confirmed.
  
  
  METHODS
  In a retrospective analysis, all patients with predicted severe acute pancreatitis without initial organ failure admitted to a medium care facility of a teaching hospital in Prague from January 2003 to December 2010 were included. All patients routinely received probiotic treatment with Probioflora. Total parenteral nutrition (TPN) was routinely started and shifted toward total enteral nutrition. Infectious complications, mortality and the incidence of bowel ischemia were recorded.
  
  
  RESULTS
  99 consecutive patients, mean age 56 years, were included. Infectious complications occurred in 42 patients (42%), consisting of bacteremia (n = 40), pneumonia (n = 11) and infected necrosis (n = 11). Bowel ischemia was detected in two patients (2%). Overall mortality was 8%.
  
  
  CONCLUSIONS
  In this retrospective study no apparent positive or negative impact of probiotic treatment with Probioflora was demonstrated when administered to patients with predicted severe acute pancreatitis without initial organ failure.
authors.affiliation: Dept. Operating Room/Evidence Based Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. markvanbaal@gmail.com
authors.forename: M C
authors.initials: MC
authors.lastname: van Baal
authors.forename: P
authors.initials: P
authors.lastname: Kohout
authors.forename: M G
authors.initials: MG
authors.lastname: Besselink
authors.forename: H C
authors.initials: HC
authors.lastname: van Santvoort
authors.forename: Z
authors.initials: Z
authors.lastname: Benes
authors.forename: R
authors.initials: R
authors.lastname: Zazula
authors.forename: G T
authors.initials: GT
authors.lastname: Rijkers
authors.forename: H G
authors.initials: HG
authors.lastname: Gooszen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000517:prevention & control; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000401:mortality / Q000628:therapy*; D019283:Pancreatitis, Acute Necrotizing / Q000517:prevention & control*; D010289:Parenteral Nutrition, Total; D019936:Probiotics / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome