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Bugs or Drugs: Are Probiotics Safe for Use in the Critically Ill?
Abstract
Probiotics are living microorganisms which have demonstrated many benefits in prevention, mitigation, and treatment of various disease states in critically ill populations. These diseases include antibiotic-associated diarrhea, Clostridium difficile diarrhea, ventilator-associated pneumonia, clearance of vancomycin-resistant enterococci from the GI tract, pancreatitis, liver transplant, major abdominal surgery, and trauma. However, their use has been severely limited due to a variety of factors including a general naïveté within the physician community, lack of regulation, and safety concerns. This article focuses on uses for probiotics in prevention and treatment, addresses current concerns regarding their use as well as proposing a protocol for safe use of probiotics in the critically ill patient.
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Individual differences in microbiomes further complicate the problem of probiotic efficacy and safety.
“Individual differences in microbiomes further complicate the problem [87,139].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [139]
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The Use of Prebiotics, Probiotics, and Synbiotics in the Critically Ill
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Metadata
- Authors
- Urben, L. M., Wiedmar, J., Boettcher, E., Cavallazzi, R., Martindale, R. G., & McClave, S. A.
- Affiliations
- University of Louisville Hospital (US)
- Kaiser Permanente (US)
- University of Louisville (US)
- Oregon Health & Science University (US)
- Corresponding author
- McClave, Stephen A.
- Venue
- Current Gastroenterology Reports
- Published
- 2014-07
- Volume
- 16
- Issue
- 7
- Pages
- 388-388
- ISSN
- 1522-8037 (ISSN-L)
- 1534-312X
- OpenAlex
- W1976708148
- Cited by
- 29
- References
- 85
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 3 · 2017: 8 · 2016: 4 · 2015: 2
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Current Gastroenterology Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- probiotics, critically ill patients, probiotic safety, antibiotic-associated diarrhea, Clostridium difficile-associated diarrhea, ventilator-associated pneumonia, vancomycin-resistant enterococci, pancreatitis, liver transplantation, major abdominal surgery, trauma (physical injury), probiotic regulation
- MeSH terms
- Abdomen, Acute Disease, Anti-Bacterial Agents, Clinical Protocols, Diarrhea, Humans, Opportunistic Infections, Pancreatitis, Liver Transplantation, Critical Illness, Probiotics, Perioperative Care, Pneumonia, Ventilator-Associated
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