Meta analysis of probiotics in prevention of spontaneous bacterial peritonitis in patients with cirrhosis

Objective To systematically review the efficacy of probiotics in prevention of spontaneous bacterial peritonitis in patients with cirrhosis. Methods Pubmed, Cochrane Library, China National Knowledge Internet (CNKI), Chinese Biomedical Literature Database (CBM), Chinese Journal Full-Text Database (CJFD), Wanfang database, and CQVIP database (from January 2000 to March 2015) were searched to collect randomized controlled trials (RCTs) which comparing the efficacy of probiotics combined with or without other treatments to placebo in the prevention of spontaneous bacterial peritonitis in patients with cirrhosis. Two reviewers independently evaluated the quality of included articles and extracted the data. Statistical analysis was performed using Review Manager 5.2. Results Ten essays were enrolled in this research which included totally 789 cases. Of the 789 cases, 371 cases were in observation group (treated by probiotics and liver protection drugs) and 418 cases were in control group (treated by liver protection drugs). Meta analysis showed that in the prevention of spontaneous bacterial peritonitis, probiotics were superior to placebo (OR = 0.34, 95% CI: 0.22-0.53, P< 0.000 1) and no significant differences were observed between probiotics and antibiotics (OR=0.78, 95% CI: 0.43-1.44, P> 0.05). Conclusion Probiotics and antibiotic are effective in preventing spontaneous peritonitis in patients with hepatic cirrhosis.