Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme
Yıl: 2023 Cilt: 28 Sayı: 1 Sayfa Aralığı: 19 - 36 Metin Dili: Türkçe DOI: 10.5578/flora.20239902 İndeks Tarihi: 02-05-2023
Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme
Öz: Bu çalışmanın amacı, probiyotiklerin çeşitli hastalıkların tedavisinde, profilaksisinde ve vücudun mikrobiyotası üzerindeki etkisinin araştırılması için tek veya kombinasyon halinde farklı mikroorganizmaları içeren probiyotik kullanımı hakkında mevcut bilgilerin analiz edilmesidir. Pubmed, Google Scholar, SCOPUS, EMBASE, Cochrane Library of Systematic Reviews, CINAHL, AMED, Türk Medline elektronik veri tabanlarına ek olarak gri literatür 2004-2021 yıllarını kapsayacak biçimde tarandı. Belirlenen seçim kriterleri içinde yer alan randomize kontrollü çalışmalar (RKÇ) bir araya getirildi. RKÇ’ler, Cochrane yanlılık riski aracı kullanılarak değerlendirildi. Toplamda dahil edilen 32 RKÇ’nin 14’ünde yalnızca maya (Saccharomyces spp.), altısında yalnızca Lactobacillus spp., dördünde yalnızca Bifidobacterium spp., altısında birden fazla bakteri cinsi içeren probiyotik takviyesi uygulanmıştır. Dahil edilen çalışmaların yalnızca 10/32 tanesi probiyotik suşu tam olarak bildirmiş olup 22/32 tanesi yalnızca tür düzeyinde bildirim yapmıştır. Diyare tedavisi için probiyotik kullanılan dokuz çalışmanın tamamında probiyotiklerin diyare süresini ve hastanede yatış süresini kısalttığı bildirilmiştir. Nekrotizan enterokolit tedavisinde probiyotik kullanımı bildiren beş çalışmanın dördü, probiyotiklerin nekrotizan enterokolit insidansını azaltmada etkili olmadığını ancak beslenme toleransını iyileştirebildiğini raporlamıştır. Helicobacter pylori infeksiyonu tedavisinde probiyotiklerin kullanımını araştıran dört RKÇ’nin ikisinde eradikasyon tedavisine bağlı yan etkilerin azaldığı ifade edilmiştir. Profilaksi amaçlı yapılan çalışmalardan ikisinde de probiyotiklerin antibiyotiğe bağlı diyareyi önlediği bildirilmiştir. Bu çalışma, probiyotiklerin çeşitli hastalıkların tedavi endikasyonları ve profilaksisi için olumlu sonuçları olduğunu göstermektedir. Bu sağlık faydalarının sürdürülebilirliği ve probiyotiklerin güvenli uygulanması için kullanılan suş bilgilerinin belirtildiği, yan etki bildirimlerine de yer veren daha fazla araştırmaya ihtiyaç vardır.
Anahtar Kelime: The Use of Probiotics in the Treatment and Prophylaxis of Various Diseases in Türkiye: A Systematic Review
Öz: The aim of this study is to analyze the available information on the use of probiotics containing different microorganisms, singly or in combination, in order to investigate the effect of probiotics on the treatment, prophylaxis and microbiota of various diseases. In addition to Pubmed, Google Scholar, SCOPUS, EMBASE, Cochrane Library of Systematic Reviews, CINAHL, AMED, Turkish Medline electronic databases, the gray literature was searched to cover the years 2004-2021. Randomized controlled studies (RCTs) included in the specified selection criteria were brought together. RCTs were evaluated using the Cochrane risk of bias tool. Of the 32 RCTs included in total, only yeast (Saccharomyces spp.) was administered in fourteen, only Lactobacillus spp. in six, Bifidobacterium spp. only in four, and probiotic supplementation containing more than one bacterial strain in six. Only 10/32 of the included studies fully reported the probiotic strain, and 22/32 reported only at the species level. In all nine studies using probiotics for the treatment of diarrhea, probiotics were reported to shorten the duration of diarrhea and length of hospital stay. Four of the five studies reporting the use of probiotics in the treatment of necrotizing enterocolitis reported that probiotics were not effective in reducing the incidence of necrotizing enterocolitis, but could improve nutritional tolerance. In two of the four RCTs investigating the use of probiotics in the treatment of Helicobacter pylori infection, it was stated that the side effects associated with eradication therapy decreased. In both studies conducted for prophylaxis, it was reported that probiotics prevent antibiotic-associated diarrhea. This study shows that probiotics have positive results for the treatment indications and prophylaxis of various diseases. For the sustainability of these health benefits and the safe administration of probiotics, more research is needed that includes strain information and side effect reports
Anahtar Kelime: Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
- 1. Koboziev I, Reinoso Webb C, Furr KL, Grisham MB. Role of the enteric microbiota in intestinal homeostasis and inflammation. Free Radic Biol Med 2014;68:122-33. https://doi. org/10.1016/j.freeradbiomed.2013.11.008
- 2. Sekirov I, Russell SL, Antunes LC, Finlay BB. Gut microbiota in health and disease. Physiol Rev 2010;90:859-904. https://doi.org/10.1152/physrev.00045.2009
- 3. Smith K, McCoy KD, Macpherson AJ. Use of axenic animals in studying the adaptation of mammals to their commensal intestinal microbiota. Semin Immunol 2007;19:59-69. https://doi.org/10.1016/j.smim.2006.10.002
- 4. Wu HJ, Wu E. The role of gut microbiota in immune homeostasis and autoimmunity. Gut Microbes 2012;3:4-14. https://doi.org/10.4161/gmic.19320
- 5. Fong W, Li Q, Yu J. Gut microbiota modulation: A novel strategy for prevention and treatment of colorectal cancer. Oncogene 2020;39:4925-43. https://doi.org/10.1038/ s41388-020-1341-1
- 6. Geier MS, Butler RN, Howarth GS. Probiotics, prebiotics and synbiotics: A role in chemoprevention for colorectal cancer? Cancer Biol Ther 2006;5:1265-9. https://doi.org/10.4161/ cbt.5.10.3296
- 7. Cannon J, Lee T, Bolanos J, Danziger L. Pathogenic relevance of Lactobacillus: A retrospective review of over 200 cases. Eur J Clin Microbiol Infect Dis 2005;24:31-40. https://doi.org/10.1007/s10096-004-1253-y
- 8. Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis 2015;60:129-34. https://doi.org/10.1093/cid/ civ085
- 9. Joint FAO/WHO Expert Committee on Food Additives. Meeting, World Health Organization. Evaluation of Certain Food Additives and Contaminants: Fifty-seventh Report of the Joint FAO/WHO Expert Committee on Food Additives. World Health Organization; 2002 Dec 13.
- 10. Gibson GR, Hutkins R, Sanders ME, Prescott SL, Reimer RA, Salminen SJ, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol 2017;14:491- 502. https://doi.org/10.1038/nrgastro.2017.75
- 11. Gibson GR, Fuller R. Aspects of in vitro and in vivo research approaches directed toward identifying probiotics and prebiotics for human use. J Nutr 2000;130:391-5. https://doi. org/10.1093/jn/130.2.391S
- 12. Dewulf EM, Cani PD, Claus SP, Fuentes S, Puylaert PG, Neyrinck AM, et al. Insight into the prebiotic concept: Lessons from an exploratory, double blind intervention study with inulin-type fructans in obese women. Gut 2013;62:1112- 21. https://doi.org/10.1136/gutjnl-2012-303304
- 13. Azcarate-Peril MA, Ritter AJ, Savaiano D, Monteagudo- Mera A, Anderson C, Magness ST, et al. Impact of short-chain galactooligosaccharides on the gut microbiome of lactose-intolerant individuals. Proc Natl Acad Sci USA 2017;114:367-75. https://doi.org/10.1073/ pnas.1606722113
- 14. Maier TV, Lucio M, Lee LH, VerBerkmoes NC, Brislawn CJ, Bernhardt J, et al. Impact of dietary resistant starch on the human gut microbiome, metaproteome, and metabolome. mBio 2017;8:e01343-17. https://doi.org/10.1128/ mBio.01343-17
- 15. Lindsay JO, Whelan K, Stagg AJ, Gobin P, Al-Hassi HO, Rayment N, et al. Clinical, microbiological, and immunological effects of fructo-oligosaccharide in patients with Crohn’s disease. Gut 2006;55:348-55. https://doi.org/10.1136/ gut.2005.074971
- 16. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021;372:n71. https://doi.org/10.1136/bmj.n71
- 17. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins J, Churchill R, Chandler J, Cumpston M, eds. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.2.0. (updated June 2017), Cochrane; 2017.
- 18. Kurugöl Z, Koturoğlu G. Effects of Saccharomyces boulardii in children with acute diarrhoea. Acta Paediatr 2005;94:44- 7. https://doi.org/10.1080/08035250410022521
- 19. Duman DG, Bor S, Ozütemiz O, Sahin T, Oğuz D, Iştan F, et al. Efficacy and safety of Saccharomyces boulardii in prevention of antibiotic-associated diarrhoea due to Helicobacterpylori eradication. Eur J Gastroenterol Hepatol 2005;17:1357-61. https://doi.org/10.1097/00042737- 200512000-00015
- 20. Besirbellioglu BA, Ulcay A, Can M, Erdem H, Tanyuksel M, Avci IY, et al. Saccharomyces boulardii and infection due to Giardia lamblia. Scand J Infect Dis 2006;38:479-81. https://doi.org/10.1080/00365540600561769
- 21. Can M, Beşirbellioglu BA, Avci IY, Beker CM, Pahsa A. Prophylactic Saccharomyces boulardii in the prevention of antibiotic- associated diarrhea: A prospective study. Med Sci Monit 2006;12:19-22.
- 22. Cindoruk M, Erkan G, Karakan T, Dursun A, Unal S. Efficacy and safety of Saccharomyces boulardii in the 14-day triple anti-Helicobacter pylori therapy: A prospective randomized placebo-controlled double-blind study. Helicobacter 2007;12:309-16. https://doi.org/10.1111/j.1523- 5378.2007.00516.x
- 23. Caglar E, Kavaloglu SC, Kuscu OO, Sandalli N, Holgerson PL, Twetman S. Effect of chewing gums containing xylitol or probiotic bacteria on salivary mutans streptococci and lactobacilli. Clin Oral Investig 2007;11:425-9. https://doi. org/10.1007/s00784-007-0129-9
- 24. Dinleyici EC, Eren M, Yargic ZA, Dogan N, Vandenplas Y. Clinical efficacy of Saccharomyces boulardii and metronidazole compared to metronidazole alone in children with acute bloody diarrhea caused by amebiasis: A prospective, randomized, open label study. Am J Trop Med Hyg 2009;80:953-5. https://doi.org/10.4269/ajtmh.2009.80.953
- 25. Dalgic N, Sancar M, Bayraktar B, Pullu M, Hasim O. Probiotic, zinc and lactose-free formula in children with rotavirus diarrhea: Are they effective? Pediatr Int 2011;53:677-82. https://doi.org/10.1111/j.1442-200X.2011.03325.x
- 26. Sari FN, Dizdar EA, Oguz S, Erdeve O, Uras N, Dilmen U. Oral probiotics: Lactobacillus sporogenes for prevention of necrotizing enterocolitis in very low-birth weight infants: A randomized, controlled trial. Eur J Clin Nutr 2011;65:434- 9. https://doi.org/10.1038/ejcn.2010.278
- 27. Demirel G, Celik IH, Erdeve O, Dilmen U. Impact of probiotics on the course of indirect hyperbilirubinemia and phototherapy duration in very low birth weight infants. J Matern Fetal Neonatal Med 2012;26:215-8. https://doi. org/10.3109/14767058.2012.725115
- 28. Demirel G, Erdeve O, Celik IH, Dilmen U. Saccharomyces boulardii for prevention of necrotizing enterocolitis in preterm infants: A randomized, controlled study. Acta Paediatr 2013;102:560-5. https://doi.org/10.1111/apa.12416
- 29. Oncel MY, Sari FN, Arayici S, Guzoglu N, Erdeve O, Uras N, et al. Lactobacillus reuteri for the prevention of necrotising enterocolitis in very low birthweight infants: A randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 2014;99:110-5. https://doi.org/10.1136/archdischild- 2013-304745
- 30. Demirel G, Celik IH, Erdeve O, Saygan S, Dilmen U, Canpolat FE. Prophylactic Saccharomyces boulardii versus nystatin for the prevention of fungal colonization and invasive fungal infection in premature infants. Eur J Pediatr 2013;172:1321-6. https://doi.org/10.1007/s00431-013- 2041-4
- 31. Serce O, Benzer D, Gursoy T, Karatekin G, Ovali F. Efficacy of Saccharomyces boulardii on necrotizing enterocolitis or sepsis in very low birth weight infants: A randomised controlled trial. Early Hum Dev 2013;89:1033-6. https://doi. org/10.1016/j.earlhumdev.2013.08.013
- 32. Dinleyici EC, Vandenplas Y; PROBAGE Study Group. Lactobacillus reuteri DSM 17938 effectively reduces the duration of acute diarrhoea in hospitalised children. Acta Paediatr 2014;103:300-5. https://doi.org/10.1111/apa.12617
- 33. Erdeve O, Tiras U, Dallar Y. The probiotic effect of Saccharomyces boulardii in a pediatric age group. J Trop Pediatr 2004;50:234-6. https://doi.org/10.1093/tropej/50.4.234
- 34. Serce O, Gursoy T, Ovali F, Karatekin G. Effects of Saccharomyces boulardii on neonatal hyperbilirubinemia: A randomized controlled trial. Am J Perinatol 2015;30:137-42. https://doi.org/10.1055/s-0034-1376390
- 35. Dilli D, Aydin B, Fettah ND, Özyazıcı E, Beken S, Zenciroğlu A, et al. The propre-save study: Effects of probiotics and prebiotics alone or combined on necrotizing enterocolitis in very low birth weight infants. J Pediatr 2015;166:545-51. https://doi.org/10.1016/j.jpeds.2014.12.004
- 36. Dinleyici EC, Kara A, Dalgic N, Kurugol Z, Arica V, Metin O, et al. Saccharomyces boulardii CNCM I-745 reduces the duration of diarrhoea, length of emergency care and hospital stay in children with acute diarrhoea. Benef Microbes 2015;6:415-21. https://doi.org/10.3920/BM2014.0086
- 37. Dinleyici EC, Dalgic N, Guven S, Metin O, Yasa O, Kurugol Z, et al. Lactobacillus reuteri DSM 17938 shortens acute infectious diarrhea in a pediatric outpatient setting. J Pediatr (Rio J) 2015;91:392-6. https://doi.org/10.1016/j. jped.2014.10.009
- 38. Baştürk A, Artan R, Yılmaz A. Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: A randomized controlled trial. Turk J Gastroenterol 2016;27:439-43. https://doi.org/10.5152/ tjg.2016.16301
- 39. Ustundag GH, Altuntas H, Soysal YD, Kokturk F. The effects of synbiotic “Bifidobacterium lactis B94 plus Inulin” addition on standard triple therapy of helicobacter pylori eradication in children. Can J Gastroenterol Hepatol 2017;2017:8130596. https://doi. org/10.1155/2017/8130596
- 40. Çekin AH, Şahintürk Y, Akbay Harmandar F, Uyar S, Yolcular BO, Çekin Y. Use of probiotics as an adjuvant to sequential H. pylori eradication therapy: Impact on eradication rates, treatment resistance, treatment-related side effects, and patient compliance. Turk J Gastroenterol 2017;28:3-11. https://doi.org/10.5152/tjg.2016.0278
- 41. Kuru BE, Laleman I, Yalnızoğlu T, Kuru L, Teughels W. The influence of a bifidobacterium animalis probiotic on gingival health: A randomized controlled clinical trial. Journal of Periodontology 2017;88:1115-23. https://doi. org/10.1902/jop.2017.170213
- 42. Mutlu M, Aslan Y, Kader Ş, Aktürk Acar F. Preventive effects of probiotic supplementation on neonatal hyperbilirubinemia caused by isoimmunization. Am J Perinatol 2020;37:1173- 6. https://doi.org/10.1055/s-0039-1692690
- 43. Basturk A, Isik İ, Atalay A, Yılmaz A. Investigation of the efficacy of Lactobacillus rhamnosus GG in infants with cow’s milk protein allergy: A randomised double-blind placebo-controlled trial. Probiotics Antimicrob Proteins 2020;12:138-43. https://doi.org/10.1007/s12602-019-9516-1
- 44. Dinleyici EC, Dalgic N, Guven S, Ozen M, Kara A, Arica V, et al. The effect of a multispecies synbiotic mixture on the duration of diarrhea and length of hospital stay in children with acute diarrhea in Turkey: Single blinded randomized study. Eur J Pediatr 2013;172:459-64. https://doi. org/10.1007/s00431-012-1903-5
- 45. Akcam M, Koca T, Salman H, Karahan N. The effects of probiotics on treatment of Helicobacter pylori eradication in children. Saudi Med J 2015;36:286-90. https://doi. org/10.15537/smj.2015.3.10124
- 46. Yazar AS, Guven S, Dinleyici EC. Effects of zinc or synbiotic on the duration of diarrhea in children with acute infectious diarrhea. Turk J Gastroenterol 2016;27:537-40. https:// doi.org/10.5152/tjg.2016.16396
- 47. Güney-Varal İ, Köksal N, Özkan H, Bağcı O, Doğan P. The effect of early administration of combined multi-strain and multi-species probiotics on gastrointestinal morbidities and mortality in preterm infants: A randomized controlled trial in a tertiary care unit. Turk J Pediatr 2017;59:13-9. https:// doi.org/10.24953/turkjped.2017.01.003
- 48. Gurpinar B, Yildirim G, Kumral TL, Akgun MF, Sari H, Tutar B, et al. A simple method to reduce halitosis; tongue scraping with probiotics. J Breath Res 2019;14:016008. https:// doi.org/10.1088/1752-7163/ab503e
- 49. Ercan N, Olgun E, Kisa Ü, Yalim M. Effect of synbiotics in the treatment of smokers and non-smokers with gingivitis: Randomized controlled trial. Aust Dent J 2020;65:210-9. https://doi.org/10.1111/adj.12755
- 50. Probiotic Advisor. Dosage. Available from: www.probioticadvisor. com/probiotic-essentials-2/dosage/ (Accessed date: 28.02.2023).
- 51. Fijan S. Microorganisms with claimed probiotic properties: An overview of recent literature. IJSERPH 2014;11:4745- 67. https://doi.org/10.3390/ijerph110504745
- 52. Wilkins T, Sequoia J. Probiotics for gastrointestinal conditions: A summary of the evidence. AFP 2017;96:170-8.
- 53. Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating acute infectious diarrhoea. Cochrane Database Syst Rev 2010:CD003048. https://doi.org/10.1002/14651858. CD003048.pub3
- 54. Shan L, Hou P, Wang Z, Liu FR, Chen N, Shu LH, et al. Prevention and treatment of diarrhoea with Saccharomyces boulardii in children with acute lower respiratory tract infections. Beneficial Microbes 2013;4:329- 34. https://doi. org/10.3920/BM2013.0008
- 55. Song H, Kim J, Jung S, Kim SE, Park HS, Jeong Y, et al. Effect of probiotic Lactobacillus (Lacidofil® Cap) for the prevention of antibiotic-associated diarrhea: A prospective, randomized, double-blind, multicenter study. J Korean Med Sci 2010;25:1784-91. https://doi.org/10.3346/ jkms.2010.25.12.1784
- 56. Adam J, Barret A, Barret-Bellet C. Essais Cliniques Controles en Double insu de L’ultra-levure Lyophilisee: Etude Multicentrique par 25 medecins e 388 cas. Gazz Med Fr 1977;5:2072-8.
- 57. Surawicz CM, Elmer GW, Speelman P, McFarland LV, Chinn J, van Belle G. Prevention of antibiotic associated diarrhoea by Saccharomyces boulardii: A prospective study. Gastroenterology 1989; 96(4):981-8. https://doi. org/10.1016/0016-5085(89)91613-2
- 58. Sen M. Role of probiotics in health and disease: A review. IJALSR 2019;2:1-11. https://doi.org/10.31632/ijalsr. 2019v02i02.001
- 59. Aceti A, Gori D, Barone G, Callegari ML, Di Mauro A, Fantini MP, et al. Probiotics for prevention of necrotizing enterocolitis in preterm infants: Systematic review and meta-analysis. Ital J Pediatr 2015;41:89. https://doi.org/10.1186/ s13052-015-0199-2
- 60. Rojas MA, Lozano JM, Rojas MX, Rodriguez VA, Rondon MA, Bastidas JA, et al. Prophylactic probiotics to prevent death and nosocomial infection in preterm infants. Pediatrics 2012;130:e1113-20. https://doi.org/10.1542/ peds.2011-3584
- 61. Laleman I, Yilmaz E, Ozcelik O, Haytac C, Pauwels M, Herrero ER, et al. The effect of a streptococci containing probiotic in periodontal therapy: A randomized controlled trial. J Clin Periodontol 2015;42:1032-41 https://doi. org/10.1111/jcpe.12464
- 62. Szkaradkiewicz AK, Stopa J, Karpiski TM. Effect of oral administration involving a probiotic strain of Lactobacillus reuteri on pro-inflammatory cytokine response in patients with chronic periodontitis. Arch Immunol Ther Exp (Warsz) 2014;62:495-500. https://doi.org/10.1007/s00005-014- 0277-y
- 63. Hojo K, Nagaoka S, Murata S, Taketomo N, Ohshima T, Maeda N. Reduction of vitamin K concentration by salivary Bifidobacterium strains and their possible nutritional competition with Porphyromonas gingivalis. J Appl Microbiol 2007;103:1969-74. https://doi.org/10.1111/j.1365- 2672.2007.03436.x
- 64. Yamamoto S, Saito M, Tamura A, Prawisuda D, Mizutani T, Yotsuyanagi H. The human microbiome and COVID-19: A systematic review. PLoS ONE 2021;16:e0253293. https:// doi.org/10.1371/journal.pone.0253293
- 65. Li J, Zhao J, Wang X. Novel angiotensin-converting enzyme- inhibitory peptides from fermented bovine milk started by Lactobacillus helveticus KLDS.31 and Lactobacillus casei KLDS.105: Purification, identification, and interaction mechanisms. Front Microbiol 2019;10:2643. https://doi. org/10.3389/fmicb.2019.02643
- 66. Besselink M, van Santvoort H, Buskens E, Boermeester MA, van Goor H, Timmerman HM, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: A randomised, double-blind, placebo-controlled trial. The Lancet 2008;371:651-9. https://doi.org/10.1016/S0140- 6736(08)60207-X
- 67. Coviello CC, Corsini II, Arena F, Antonelli A, Rossolini G, Dani C. Lactobacillus sepsis and probiotic therapy in newborns: Two new cases and literature review. AJP Rep 2015;06:25- 9. https://doi.org/10.1055/s-0035-1566312
- 68. Chatterjee A, Bhattacharya H, Kandwal A. Probiotics in periodontal health and disease. J Indian Soc Periodontol 2011;15:23-8. https://doi.org/10.4103/0972-124X.82260
| APA | Kahraman Kılbaş E, Altindis M (2023). Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. , 19 - 36. 10.5578/flora.20239902 |
| Chicago | Kahraman Kılbaş Elmas Pınar,Altindis Mustafa Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. (2023): 19 - 36. 10.5578/flora.20239902 |
| MLA | Kahraman Kılbaş Elmas Pınar,Altindis Mustafa Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. , 2023, ss.19 - 36. 10.5578/flora.20239902 |
| AMA | Kahraman Kılbaş E,Altindis M Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. . 2023; 19 - 36. 10.5578/flora.20239902 |
| Vancouver | Kahraman Kılbaş E,Altindis M Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. . 2023; 19 - 36. 10.5578/flora.20239902 |
| IEEE | Kahraman Kılbaş E,Altindis M "Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme." , ss.19 - 36, 2023. 10.5578/flora.20239902 |
| ISNAD | Kahraman Kılbaş, Elmas Pınar - Altindis, Mustafa. "Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme". (2023), 19-36. https://doi.org/10.5578/flora.20239902 |
| APA | Kahraman Kılbaş E, Altindis M (2023). Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 28(1), 19 - 36. 10.5578/flora.20239902 |
| Chicago | Kahraman Kılbaş Elmas Pınar,Altindis Mustafa Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 28, no.1 (2023): 19 - 36. 10.5578/flora.20239902 |
| MLA | Kahraman Kılbaş Elmas Pınar,Altindis Mustafa Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, vol.28, no.1, 2023, ss.19 - 36. 10.5578/flora.20239902 |
| AMA | Kahraman Kılbaş E,Altindis M Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2023; 28(1): 19 - 36. 10.5578/flora.20239902 |
| Vancouver | Kahraman Kılbaş E,Altindis M Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2023; 28(1): 19 - 36. 10.5578/flora.20239902 |
| IEEE | Kahraman Kılbaş E,Altindis M "Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme." Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 28, ss.19 - 36, 2023. 10.5578/flora.20239902 |
| ISNAD | Kahraman Kılbaş, Elmas Pınar - Altindis, Mustafa. "Türkiye’de Probiyotiklerin Çeşitli Hastalıkların Tedavisi ve Profilaksisinde Kullanımı: Sistematik Derleme". Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 28/1 (2023), 19-36. https://doi.org/10.5578/flora.20239902 |
