Sunday, February 3, 2008

Dangerous probiotics? Probably not

Readers may have been concerned to hear last week of 24 unexplained deaths among patients with acute pancreatitis, who were being administered probiotics in a study conducted at the University Medical Centre in Utrecht. The deaths occurred between 2004 and 2007 and represented 16% of the 296 patients in the trial. Unfortunately, the original reports are in Dutch and it is difficult to glean the full facts, including the percentage of patients in the control group who died.

It appears that the patients all had serious acute pancreatitis – inflammation of the pancreas. This disease may have a number of causes, but alcohol abuse and gallstones account for 80-90% of cases. Scarring of the pancreas during an attack may lead to chronic disease that can become life threatening.

The research concerned the functioning of probiotic bacteria administered to reduce the effects of the pancreatitis. The investigation was conducted in fifteen hospitals under the guidance of UMC Utrecht. If I have interpreted the press reports correctly, an investigation of the deceased showed that no infection resulted from the administration of the probiotics. However, three factors appear to be involved: treatment with probiotics of patients having organ failure; treatment of patients in intensive care; treatment of patients being fed by probe directly into the digestive tract. The researchers have recommended that if a patient satisfies one or more of these criteria, they should not be administered probiotics. A similar trial in Czechia has been stopped.

It had been thought that the administration of probiotic bacteria would raise the patients’ resistance to detrimental bacteria colonizing the gut.

Not surprisingly, the main manufacturers of probiotic cultures have reacted strongly, stating that there is no evidence that feeding of probiotics has a deleterious effect on healthy individuals. They have also claimed that the bacteria in the study are different from those in their own products.

I’m sure we haven’t heard the last of this, but in the meantime I suggest that normal, healthy adults should continue eating their probiotic-containing yoghurt or drinking their daily dose of probiotic cultures. The benefits of probiotic bacteria have been known for many years and countless people have consumed them without apparent ill effects. Extrapolating from patients who were already seriously unwell to normal healthy individuals is ill advised.

This morning my muesli and strawberries tasted just great with the addition of probiotic yoghurt!

2 comments:

Terry said...

Hi John,
Just wondering if you know if.
Theralac and TruFlora is a safe antibiotic to take.

John said...

Terry
I can't recommend or endorse commercial products. I have not had any contact with the manufacturers of these probiotics, neither have I analysed the products.

However, I found a link for independent quality assurance and certificates of analysis for Theralac at:
http://www.theralac.com/Quality.aspx
and for TruFlora (appears to be the same manufacturer and testing laboratory):
http://www.truflora.com/Quality.aspx

If you go to those websites, you can check individual lots of product.

Incidentally, you referred to these products as "antibiotics". They are in fact "Probiotics" which are "consumable products that contain live organisms that are, or are believed to be beneficial to the consumer" (Jay et al., Modern Food Microbiology, 2005). These bacteria have various effects on digestion and health of the digestive tract.

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