CC Sept 2015 Probiotics

echoecho's version from 2015-11-11 03:03


Question Answer
Define probiotics?"live microorganisms which (when administered in adequate amoutngs), confer a health benefit on the host
List the 5 beneficial effects of probiotics?1) providing a protective barrier 2) altering intensitnal pH to favor the growth of nonpathogenic bacteria 3) enhancing the hosts immunologic response 4) producing antimicrobial substances 5) directly competing with pathogenic bacteria for receptors in the GI tract
What has led to an underexposed immune system?our obsession with antimicrobials and cleanliness
*** Probiotics shorten the duration of and decrease stool frequency in acute infectious diarrhea. Probiotics shorten the duration of diarrhea by about ____ hours. They also reduced both the risk of diarrhea lasting longer than ____ days and stool frequency on day ___ of illness?24; 4; 2
The incidence of traveler's diarrhea is > ____% when traveling to what high-risk countries and 5-10% when traveling to what lower risk countries?1) 50% 2) Middle Esat, North Africa, Latin America, Southeast Asia 3) North America, Northern Europe, the Uited Kingdom, Australia and New Zealand
Multiple probiotic strains appear to be both safe and effective for preventing traveler's diarrhea. One study found that what mixture of bacteria prevented diarrhea in the US and European travelers to a variety of vacation spots w/ no serious adverse effects?Saccharomyces boulardii AND a Lactobacillus acidophilus / Bifidobacterium bifidum mixture
What type of treatments to the abdomen and pelvis can damage the lower GI tract and frequently cause diarrhea as a side effect?radiation treatment
What benefit do probiotics have on radiation-induced diarrhea?for the prevention of, and possible benefit for the treatment of
*** Comment on antibiotic-associated diarrhea and the role of probiotics?probiotics are effective for treating and preventing antibiotic-associated diarrhea w/ a statistically significant reduction in antibiotic-associated diarrhea in patients receiving probiotic treatment
Probiotic therapy also prevents what type of diarrhea?antibiotic associated diarrhea (AAD)
What is the pooled relative risk for AAD for pts treated w/ probiotics compared to placebo with a NNT of 8??0.53
The 2013 PLACIDE trial studied hospitalized patients > 65 yrs of age treated with antibiotics and found what regarding AAD rates in this subset of the population?no significant decrease in AAD
*** A 2008 review concluded that there was insufficient evidence for probiotic use in the treatment of what either in monotherapy or as an adjunct therapy?CDAD (Clostridium difficle-associated diarrhea)
One trial found patients receiving what probiotic in addition to antibiotic therapy were significantly less likely to experience recurrence of C. difficle diarrhea than pts receiving placebo, a benefit not found in other trials in this meta-analysis?S. boulardii
*** Probiotics decreased the incidence of CADA by ___%?66
Probiotic prophylaxis was shown to be beneficial in preventing CDAD in patients treated in the inpatient and outpatient settings, while not increasing any significant adverse effects from treatment, true or false?true
Adverse events occurred in ___% of probiotic patients, compared with ___% of control patients in those with Clostridium difficle-associated diarrhea?9.3; 12.6
Regarding Helicobacter pylori, based ont he following findings, probiotics _______ (should vs. shouldn't be an adjunct therapy when treating H. pylori?should
What type of milk-based probiotics improved H. pylori eradication rates by 5-15%?fermented
S. boulardii probiotic significantly increased H. pylori eradication rate when used as an adjunct with ____ therapy and reduced the rate of treatment related side effects?triple
What supplementation increased H. pylori eradication while decreasing incidence of side effects overall?lactobacillus supplementation
*** Regarding inflammatory bowel disease, is there any benefit of probiotic therapy for inducing remission or preventing relapse in ulcerative colitis or Crohn's disease?no
Regarding Irritable Bowel syndrome (IBS) and minor gastrointestinal symptoms, was there a benefit of probiotic therapy in patients with IBS?yes
Regarding IBS, there was a RR of 0.71 of IBS not improving in the placebo group and the study found a NNT of 4, true or false?true
*** Regarding infantile colic, much has been written about the use of probiotic for colic. What did one review find?Lactobacillus reuteri (not combined probiotics) might reduce crying time by 65 minutes per day after 21 days of therapy.
*** Regarding Necrotizing Enterocolitis (NEC), all preterm infants should be prescribed what?enteral probiotics (significantly reduced the incidence of severe NEC)
Comment on the role of probiotics in the treatment of bacterial vaginosis?there is marginal evidence of efficacy for probiotics to treat BV. Multiple studies show conflicting results
Regarding gestational diabetes, comment on probiotic use?it is uncertain whether probiotics reduce the rate of GDM (gestational DM). One small trial found a decrease in rate of GDM.
Regarding ventilator -associated pneumonia (VAP), comment on probiotic's role?use of probiotics slightly decrease the incidence of VAP, howevere mortality was not affected, nor was length of stay or other secondary outcomes
*** Regarding URTI (upper respiratory tract infections), probiotics did what?reduced the number of participants experiencing episodes of acute URTI. They also decreased the mean duration of an episode of acute URTI by 1.89 days and reduced antibiotic prescription rates for acute URTIs
*** In a large meta-analysis, what was the affect of probiotics on blood pressure?lowered systolic BP by -3.56 mm Hg and diastolic BP by -2.38 mm Hg and a greater reduction was found when multiple as compared with single species of probiotics was administered
Is there any evidence that probiotics prevent weight gain or eczema?no
What 2 bacterias are probiotic species used in many trials?1) Saccharomyces boulardii AND 2) Lactobacillus acidophilius / Bifidobacterium bifidum
Is there a "magic bullet" probiotics that is good for everything?no
Generally speaking, compare generic and brand probiotic?have the same bacteria in both
Is there any evidence that taking probiotics in the form of a capsule, powder or a dairy product is superior?no
*** SUMMARY = Probiotics can shorten the duration of what type of diarrhea?acute infectious
*** SUMMARY = Probiotics are effective in treating AND preventing what type of diarrhea?antibiotic-associated diarrhea
*** SUMMARY = Probiotics decrease the incidence of what type of diarrhea?Clostridium difficle-assocaited diarrhea
*** SUMMARY = Probiotics supplementation significantly reduces the incidence of what disease in preterm infants?severe necrotizing enterocolitis (NEC)