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Clinical Summary

Are probiotics cost-effective for preventing in-hospital infections?

Takeaway

  • Probiotics may be a cost-effective treatment for preventing ventilator-associated pneumonia, Clostridioides difficile-associated diarrhoea, and antibiotic-associated diarrhoea in hospitalised adult patients.

Why this matters

  • Despite the potential benefits of probiotics in reducing the incidence of health care-related infections, few data are available about their cost-effectiveness.

Study design

  • Researchers systematically reviewed 7 economic evaluations of probiotic treatment in hospitalised adults, including 1 randomised-controlled trial (RCT)-based analysis and 6 model-based analyses.
  • They used Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods to assess certainty in the overall cost-effectiveness evidence.
  • Funding: None disclosed.

Key results

  • 6 (86%) of 7 evaluations found favourable cost-effectiveness, but overall GRADE certainty of evidence was very low because of potential bias, imprecision, and inconsistency.
  • 3 (43%) of 7 evaluations were manufacturer-supported.

Limitations

  • Conclusions are not definitive, because of the low number of economic evaluations included in this review and low certainty of evidence.
  • Review results may not apply to paediatric populations.
  • More safety data are needed about probiotic-induced complications such as bacteraemia.
  • Future probiotic RCTs should collect cost data to inform bedside practice, clinical guidelines, and health care policy.

References


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