P0011 - The Effect of Symbiotic (Probiotic) on Septic Complications in Patients With Severe Acute Pancreatitis: A Systematic Review and Meta-Analysis

Adnan Malik, MD¹, Waseem Amjad, MD², Mahum Nadeem, MD³, Khadija Naseem, MD⁴, Abdullah Sohail, MD⁵, Umer Farooq, MD⁶, Maryam Haider, MD^7
1Loyola University Medical Center, Maywood, IL; ²Albany Medical Center, Albany, NY; ³University of Oklahoma Health Sciences Center, Oklahoma City, OK; ⁴West Virginia University, Charleston Division, Charleston, WV; ⁵West Virginia University Charleston Division, Charleston, WV; ⁶Loyola Medicine/MacNeal Hospital, Berwyn, IL; ⁷Wayne State University, Detroit Medical Center, Detroit, MI

Introduction: Severe acute pancreatitis (SAP) with major complications such as necrosis and multiple organ dysfunction syndrome (MODS) often leads to high mortality rates despite intensive treatment. This study aimed to evaluate the effect of symbiotic (probiotic) on septic complications in patients with SAP.

Methods: We searched PubMed, Cochrane CENTRAL, SCOPUS, and Web of Science for relevant clinical trials and excluded observational studies. Quality appraisal was evaluated according to GRADE and we assessed the risk of bias using Cochrane’s risk of bias tool. We included the following outcomes: C-reactive protein (CRP), APACHE Ⅱ score, hospital stay, multiorgan failure (MOF), systemic inflammatory response syndrome, Infected pancreatic necrosis, septicemia, need for operation, and death. We performed the analysis of homogeneous data under fixed-effects model, while analysis of heterogeneous data were analyzed under random-effects model. We performed the analysis of dichotomous outcomes using risk ratio (RR) and relative 95% confidence interval (CI).

Results: We included a total of seven clinical trials. We found that there was no significant difference between both groups regarding MOF (RR= 0.60 [0.25, 1.44]) (P = 0.26), septicemia (RR= 0.66 [0.29, 1.50]), (P = 0.32), death (RR= 0.66 [0.19, 2.26]), (P = 0.51), infected pancreatic necrosis (RR= 0.50 [0.18, 1.38]), (P = 0.18), and SIRS (RR = 0.81 [0.29, 2.23]), (P = 0.68),CRP,APACHE Ⅱ score, and hospital stay.

Discussion: Contrary to some published trials, our meta-analysis concludes that the use of probiotics in patients with SAP is not effective in reducing mortality rate, septic complications, and need for surgery.


Disclosures:


Adnan Malik, MD¹, Waseem Amjad, MD², Mahum Nadeem, MD³, Khadija Naseem, MD⁴, Abdullah Sohail, MD⁵, Umer Farooq, MD⁶, Maryam Haider, MD⁷. P0011 - The Effect of Symbiotic (Probiotic) on Septic Complications in Patients With Severe Acute Pancreatitis: A Systematic Review and Meta-Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.