Probiotics in severe acute pancreatitis

In today's Lancet, Marc Besselink and colleagues 1 Besselink MGH van Santvoort HC Buskens E et al. for the Dutch Acute Pancreatitis Study GroupProbiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet. 2008; 371: 651-659 Summary Full Text Full Text PDF PubMed Scopus (1023) Google Scholar report an interesting and demanding attempt to ameliorate the course of predicted severe acute pancreatitis. These investigators used probiotic therapy early in the onset of an episode, in a randomised, double-blind, placebo-controlled multicentre trial in nearly 300 patients—the PROPATRIA study. Probiotics or con?Online publication during the past week of two randomised trials of probiotics will intensify debate about their role as nutritional supplements. In the largest study of probiotics to date, the Dutch Acute Pancreatitis Study Group, writing in The Lancet, showed that a combination of lactobacilli and bifidobacteria more than doubled mortality compared with placebo in 298 patients with predicted severe acute pancreatitis. By contrast, David Pyne and colleagues report in the British Journal of Sports Medicine, that another species of lactobacillus halved the frequency of respiratory infections in 20 high-performance distance runners. Full-Text PDF Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trialIn patients with predicted severe acute pancreatitis, probiotic prophylaxis with this combination of probiotic strains did not reduce the risk of infectious complications and was associated with an increased risk of mortality. Probiotic prophylaxis should therefore not be administered in this category of patients. Full-Text PDF