PROBIOTICS FROM THE POSITION OF EVIDENCE-BASED MEDICINE
DOI:
https://doi.org/10.11603/2312-0967.2019.3.10391Keywords:
probiotics, evidence-based medicine, the Cochrane library, systematic reviewsAbstract
The aim of the work. To systematize the data of evidence-based medicine about probiotics, taking into account the degree of confirmation of their effectiveness in the prevention and treatment of various diseases.
Materials and methods. The research material was systematic reviews of the Cochrane library for the period from 2006 to 2018, methods used: information search, analysis and generalization.
Results and discussion. Systematic reviews of the effectiveness and safety of using probiotics have been ranked by date and topic. It has been shown that the relevance of studying the effectiveness of probiotics is increasing. It has been established that the largest share of systematic reviews is devoted to the use of probiotics in gastroenterology.
The safety of probiotic therapy has been confirmed and it has been determined that in order to achieve an effect similar to the one obtained in randomized clinical trials, the same form and dose of a probiotic as in the study should be used. The positive effect of probiotics observed in patients of one age is not extrapolated to patients of other age, and the effect of a certain probiotic is not transferred to other species and strains of probiotic microorganisms.
Conclusions. Based on the analysis of the data of the Cochrane library, 32 systematic reviews of the effectiveness and safety of the use of probiotics have been identified, which are divided into four groups: with verified efficacy; with proven efficacy requiring additional randomized clinical trials; with insufficient evidence of efficacy, but with the prospect of further randomized clinical trials; with unverified efficacy. According to the systematic reviews of the first group, it has been established that the clinically justified direction of the use of probiotics is the prevention of antibiotic-associated diarrhea and the treatment of acute infectious diarrhea.
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