Probiotics for the prevention of ventilator-associated pneumonia

Abstract

Evaluation of: Morrow LE, Kollef MH, Casale TB. Probiotic prophylaxis of ventilator-associated pneumonia: a blinded, randomized, controlled trial. Am. J. Respir. Crit. Care Med. DOI: 10.1164/rccm.200912-1853OC (2010) (Epub ahead of print).

In a recently conducted randomized double-blind placebo-controlled trial, probiotics were compared with placebo in mechanically ventilated patients at risk for ventilator-associated pneumonia (VAP). Microbiologically documented VAP, Clostridium difficile-associated diarrhea and colonization by pathogenic bacteria were less frequent in probiotic-treated patients. We used this opportunity to update a relevant meta-analysis of similar trials. Using a random-effects model, we found a nonsignificant trend towards a lower incidence of VAP in patients treated with a probiotic formulation versus controls (seven studies, 994 patients; pooled odds ratio: 0.60; 95% CI: 0.35–1.02); all-cause mortality did not differ (six studies, 786 patients; odds ratio: 0.84; 95% CI: 0.59–1.18).

Keywords::

• artificial respiration
• Clostridium difficile
• critical illness
• mechanical ventilation
• nosocomial pneumonia
• prebiotics
• probiotics

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.