Prebiotics, probiotics, and synbiotics therapy in critically ill patients: a systematic review and network meta-analysis
Authors' conclusion
Synbiotics and prebiotics were associated with a significantly lower risk of gastrointestinal symptoms in critically ill patients, whereas probiotics showed a similar but statistically nonsignificant effect. No active intervention was significantly superior to another.
Study context
- Population
- Critically ill adults
- Participants
- 5,073 adults · 33 RCTs
- Comparison
- Prebiotics, probiotics or synbiotics vs control
- Outcome
- GI symptom incidence
Methodological detailsfrequentist random-effects network meta-analysis (NMA), exploratory treatment rankings, certainty of evidence not formally assessed
- Frequentist random-effects NMA
- Exploratory treatment rankings
- Certainty of evidence not formally assessed
Pooled result
As reported in the abstract
GI symptoms
Each group vs controlRelative risk (95% CI)
Synbiotics
0.52(0.35–0.77)
Prebiotics
0.66(0.49–0.87)
Probiotics
0.81(0.60–1.10)
Further pooled results
Gastrointestinal (GI) symptoms, medical vs surgical intensive care unit (ICU) patients (subgroup)
- Medical ICU: prebiotics associated with lower risk vs control; surgical ICU: probiotics and synbiotics associated with lower risk
Original publication
Prebiotics, probiotics, and synbiotics therapy in critically ill patients: a systematic review and network meta-analysis. Ann Intensive Care. Published 4 August 2026. doi:10.
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