L. plantarum 299, (2 × 109 cfu) with fibres; heat killed bacteria as placebo
For all patients before surgery. After surgery in cases of expected or proven infection.
Oral (for 4 days after surgery)
0%/3%
Lower incidence of surgical site infections, however not statistically significant. Placebo group received antibiotic therapy significantly longer than group with probiotics and fibres.
S. aureus, E. faecalis, Enterococcus faecium, Enterobacter cloacae
Lactobacillus casei Shirota, Bifidobacterium breve Yakult/(2 × 108 cfu)
For all patients before surgery. After surgery in cases of expected or proven infection.
Oral (for 14 days after surgery)
14.3%/26.1%
Significantly lower incidence of overall infections in the synbiotics group. Lower, but not statistically significant, incidence of wound infections. Slightly lower duration of postoperative antibiotic therapy for synbiotics group.
Pediococcus pentosaceus LMG P-20608, Leuconostoc mesenteroides LMG P-20607, Lactobacillus paracasei subsp. paracasei LMG P-17806; L. plantarum LMG P-20606 (1010 cfu)
For all patients before surgery. After surgery in case of bacterial infection.
Oral (starting on the day of surgery for two weeks)
0%/3%
Lower incidence of wound infection for probiotics with prebiotics group, significantly lower overall postoperative bacterial infections in the same group. Significantly lower duration of antibiotic therapy in synbiotics group.
L. casei Shirota, B. breve Yakult/(before surgery 5 × 1010 cfu); (after surgery 2 × 108 cfu)
For all patients before surgery. After surgery if needed.
Oral (14 days before and 1st day after surgery for 14 days) or after surgery for 14 days
4.8%–15%/NR
Lower incidence of wound infection for probiotics with prebiotics perioperative and postoperative treatment, statistically significantly lower overall postoperative infections and duration of antibiotic therapy for the same group.
P. pentosaceus LMG P-20608, L. mesenteroides LMG P-20607, L. paracasei subsp. paracasei LMG P-17806; L. plantarum LMG P-20606 (1010 cfu)
For all patients before surgery. After surgery in case of bacterial infection.
Oral (starting on the day after surgery for 8 days)
10%/15%
Lower incidence of wound infection for probiotics with prebiotics group, statistically significantly lower overall postoperative infections and duration of antibiotic therapy in synbiotics group for same group.
S. aureus, P. aeruginosa, S. epidermidis, E. cloacae, K. pneumoniae, E. faecalis
L. plantarum ATCC 10241 (105 cfu)
Not administered due to extreme resistance in chronic wounds.
Daily topical application, 10 days
NA
Statistically significant decrease of pathogen load after 10 days () compared to day 1 with topical probiotic treatment. However, non-probiotic group was not applied.
L. acidophilus LA-14, L. plantarum LP-115, Bifidobacterium lactis BBL-04, L. casei LC-11, Lactobacillus rhamnosus LR-32, Lactobacillus brevis LBr-35/(2.75 × 1010 cfu)
Antibiotic therapy post operation, if necessary.
Oral (at least 7 days after oral fluid tolerance after operation)
5.9%/15.2%
Incidence of postoperative infections was lower for probiotic with fibre group compared to fibre only. Significantly shorter duration of antibiotic therapy in group with probiotics and fibre.
E. coli, S. aureus, P. aeruginosa, S. epidermidis, E. faecalis, Bacteroides fragilis, Serratia marcescens
Bifidobacterium bifidum (3.3 × 109 cfu)
For all patients before surgery. After surgery only for antibiotic group.
Oral (7 days before and 5 to 10 days after operation)
6.1%/17.9%
The probiotics group had a slightly higher rate of surgical site infections vs. control group. The probiotics group had a statistically significant higher rate of surgical site infections than the antibiotic group.
L. casei Shirota, B. breve Yakult/(4.0 × 1010 cfu)
For all patients before surgery.
Oral (7–11 days before surgery and reintroduced at 2–7 postoperative days)
17.3%/22.7%
Trend towards lower surgical site infection rate for synbiotic group, however not statistically significant (). Study was not blinded and no placebo product was used.
B. longum,L. acidophilus,E. faecalis/(3.0 × 107 cfu)
For all patients before surgery. After surgery if needed.
Oral 12 days (5 before, 7 after surgery)
3.3%/3.3%
No statistically significant differences in wound infection rates. Slightly lower postoperative duration of antibiotic therapy for probiotics group.
PR/CO, probiotic vs. control group; NR, not reported specifically for wound infection; NA, not applicable; strain not specified; additional antibiotic group in study (100 patients), #40 patients received postoperative synbiotics treatment and 41 patients received both preoperative and postoperative synbiotic treatment, probiotic used together with prebiotic or fibre, ##14 diabetic patients and 20 nondiabetic patients; MRSA: methicillin-resistant S. aureus, XDR: multidrug resistant.