Synbiotics in the Intensive Care Unit

Patients who require intensive care are a uniquely vulnerable population. Their concurrent comorbidities, altered nutrition, required medications, and impaired barrier function predisposes them to a host of complications including nosocomial infections. Unfortunately, such intensive care unit-acquired infections are increasingly caused by resistant pathogens, further complicating their optimal care. As such, nonantibiotic prophylaxis and/or treatment strategies are particularly appealing in this subset of patients. An increasing amount of literature, both basic science and clinical in nature. suggests that probiotic, prebiotic, and synbiotic therapies may be effective in reducing nosocomial infection rates and the adverse implications of these infections. Although existing synbiotic studies in critically ill populations often suffer from small sample sizes and methodologic limitations, our current collective knowledge suggests that synbiotic therapy is safe and viable across an array of disease states. This review summarizes our current knowledge in this area, including limitations to our current investigations.