Systematic review and meta-analysis of Saccharomyces boulardii in adult patients

被引:342
作者
McFarland, Lynne V. [1 ,2 ]
机构
[1] Puget Sound Vet Adm Healthcare Syst, Dept Hlth Serv Res & Dev, Seattle, WA 98101 USA
[2] Univ Washington, Sch Pharm, Dept Med Chem, Seattle, WA 98195 USA
关键词
Probiotic; Diarrhea; Saccharomyces boulardii; Adult patients; Meta-analysis; ANTIBIOTIC-ASSOCIATED DIARRHEA; HELICOBACTER-PYLORI INFECTION; CLOSTRIDIUM-DIFFICILE DISEASE; IRRITABLE-BOWEL-SYNDROME; ESCHERICHIA-COLI; CROHNS-DISEASE; RISK-FACTORS; IN-VITRO; CONTROLLED-TRIAL; TOXIN-A;
D O I
10.3748/wjg.v16.i18.2202
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
This article reviews the evidence for efficacy and safety of Saccharomyces boulardii (S. boulardii) for various disease indications in adults based on the peer-reviewed, randomized clinical trials and pre-clinical studies from the published medical literature (Medline, Clinical Trial websites and meeting abstracts) between 1976 and 2009. For meta-analysis, only randomized, blinded controlled trials unrestricted by language were included. Pre-clinical studies, volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis, but included in the systematic review. Of 31 randomized, placebo-controlled treatment arms in 27 trials (encompassing 5029 study patients), S. boulardii was found to be significantly efficacious and safe in 84% of those treatment arms. A meta-analysis found a significant therapeutic efficacy for S. boulardii in the prevention of antibiotic-associated diarrhea (AAD) (RR = 0.47, 95% CI: 0.35-0.63, P < 0.001). In adults, S. boulardii can be strongly recommended for the prevention of MD and the traveler's diarrhea. Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Heliobacter pylori treatment-related symptoms. S. boulardii shows promise for the prevention of C. difficile disease recurrences; treatment of irritable bowel syndrome, acute adult diarrhea, Crohn's disease, giardiasis, human immunodeficiency virus-related diarrhea; but more supporting evidence is recommended for these indications. The use of S. boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea. (C) 2010 Baishideng. All rights reserved.
引用
收藏
页码:2202 / 2222
页数:21
相关论文
共 199 条
[1]  
Adam J., 1977, Gazette Medicale de France, V84, P2072
[2]  
Al-Eidan FA, 2000, J CLIN PHARM THER, V25, P101
[3]  
Altwegg M, 1995, MED MICROBIOL LETT, V4, P417
[4]  
AMAGASE H, 2008, CLIN INFECT DIS S2, V151, pS144
[5]   Current marketplace for probiotics: A Japanese perspective [J].
Amagase, Harunobu .
CLINICAL INFECTIOUS DISEASES, 2008, 46 :S73-S75
[6]  
[Anonymous], CLIN INFECT DIS S2
[7]  
[Anonymous], 2002, JOINT FAOWHO WORKING
[8]  
Anukam KC, 2008, J CLIN GASTROENTEROL, V42, P239, DOI 10.1097/MCG.0b013e31802c7465
[9]   ETIOLOGICAL AGENTS OF DIARRHEA IN PATIENTS INFECTED BY THE HUMAN IMMUNODEFICIENCY VIRUS-1: A REVIEW [J].
Baptista Rossit, Andrea Regina ;
Musa Goncalves, Ana Carolina ;
Franco, Celia ;
Dantas Machado, Ricardo Luiz .
REVISTA DO INSTITUTO DE MEDICINA TROPICAL DE SAO PAULO, 2009, 51 (02) :59-65
[10]  
Barc MC, 2008, ANAEROBE, V14, P229, DOI 10.1016/j.anaerobe.2008.04.003