Immunonutrition in hospitalized patients: A review to assess the effectiveness of co-supplementation with glutamine and synbiotics in the reduction of healthcare-associated infections

Problem: Healthcare associated infections (HAI) and antibiotic resistance are both a health and financial issue. So far, antibiotics are the usual treatment for HAIs. Antibiotics, however, are associated with antibiotic resistance and increased morbidity and have been shown to negatively affect immune status. Alternative and complementary therapies are being studied to see if their immune-enhancing qualities can reduce HAIs and the negative effects of antibiotic use. The purpose of this literature review is to determine if glutamine and synbiotic co-supplementation can reduce HAIs in hospitalized patients. Methods: A search of PubMed, Cochrane Library, Allied and Complementary Medicine (AMED), and European (EMBASE) through the Weill Cornell Medical College Library was conducted for scholarly works that looked at the combined supplementation of glutamine and synbiotics or glutamine, prebiotics and probiotics. Results: One randomized controlled trial met the search criteria. The study, however, focused on the reduction of irritable bowel symptoms with synbiotics and not on the effects of immunonutrition on HAIs. Conclusion: The effects of glutamine and synbiotic co-supplementation in hospitalized patients have yet to be evaluated. A multicenter randomized control study is needed to determine if these immunonutrients can alter the incidence of HAIs and diarrhea in hospitalized patients.