Navigation Links
Probiotic therapy cuts risk of VAP in half for some in ICU
Date:6/16/2010

Daily use of probiotics reduced ventilator-associated pneumonia (VAP) in critically ill patients by almost half, according to new research from Creighton University School of Medicine in Omaha, Nebraska.

The study was published on the American Thoracic Society's Web site ahead of the print edition of the American Journal of Respiratory and Critical Care Medicine.

It is estimated that VAP complicates the care of up to 30 percent of critical care patients receiving mechanical ventilation. "Patients with VAP have increased morbidity, mortality and hospital costs as well as prolonged intensive care unit (ICU) and hospital lengths of stay, and increased costs."

"We chose to study probiotics in this context because VAP is increasingly caused by pathogens associated with antimicrobial resistance and the supply of novel antibiotics is essentially nonexistent for the foreseeable future," said Lee E. Morrow, M.D., M.Sc., associate professor of medicine at Creighton University and lead author. "The implication is that novel methods of prevention must be our priority."

Although previous studies have suggested that probiotics might be effective in reducing risk of VAP, the results have been limited by the quality of their design.

"We were unsure what to expect with this trial," said Dr. Morrow. "Ultimately our hope was that upon completion of this 'proof of concept' study we could demonstrate two critically important points in a patient group at high risk for developing VAP: One, that properly selected probiotic agents can be safely administered to critically ill patients; and, two, when administered to the proper study population these agents also have efficacy in disease prevention. We felt that rigorously establishing these suppositions as facts was essential in order to continue to study probiotic agents in the intensive care unit setting."

Dr. Morrow and colleagues included 138 critically ill patients from a single center to receive either placebo or probiotic therapy. Patients in the treatment arm received 2 x 109 colony-forming units of Lactobacillus rhamnosus twice dailyhalf the dose was administered as a slurry to the oropharynx and the remainder was given through nasogatsric tube. After almost 5 years, the researchers found that daily use of probiotics not only decreased VAP infections by about 50 percent compared to placebo, but also reduced the amount of antibiotics needed in comparison to placebo-treated patients. This reduction in antibiotic consumption led to significantly fewer Clostridium difficile infections in patients given probiotics. No side effects attributable to the probiotics were observed.

Meta analysis of similar studies shows an overall reduction in VAP of 39 percent with probiotics.

"Collectively, these data suggest that Lactobacillus may represent a novel, inexpensive (retail price, $2.13 per day for four tablets as administered per protocol), and non-antibiotic approach to prevention of nosocomial infections in properly selected ICU patients," said Dr. Morrow.

Because the patients were carefully selected to reduce the risk of iatrogenic infection, and over 90 percent of patients in the ICU were deemed ineligible for the study, it is important to note, Dr. Morrow cautioned, that these findings are not applicable to all ICU patients and probiotics should not be used for VAP prophylaxis beyond the population that was included in this study.

"We strongly emphasize that these data should be viewed as preliminary in nature and cannot be generalized to the general ICU population given the prolonged period of enrolment, the rigorous inclusion criteria, the large number of exclusion criteria and the small number of patients included.

Other studies have found potentially harmful effects of probiotics, underscoring the need for meticulous monitoring of patients.

"Probiotic prophylaxis of VAP using Lactobacillus rhamnosus GG appears safe and efficacious in a select population with a very high risk of VAP," concluded Dr. Morrow. "Ultimately, probiotics may fulfill a role in antimicrobial stewardship programs given the reductions in antibiotic consumption. Larger, multicenter clinical trials with more liberal inclusion criteria are needed to establish efficacy of probiotics and to allow for extrapolation to a larger at-risk population."


'/>"/>

Contact: Keely Savoie
ksavoie@thoracic.org
212-860-5814
American Thoracic Society
Source:Eurekalert

Related medicine news :

1. New Book Says Good Stress and Probiotics can Change Your Life
2. FemFlora Reformulated with New Complex of Probiotic Bacteria
3. Probiotics Beneficial for Tiniest Preemies
4. New Designs for Health Probiotic Toothpaste -- A Breakthrough in Oral Health
5. Anna & John's Special Probiotic Blend™ Just Released by Sweet Cures™, the Innovative Natural Health Products Company based in York, UK
6. ProbioticSmart.com Re-Launches Newly Expanded Online Store for Human, Pet, and Livestock Health Products and Supplements
7. Late-onset Pompe patients in US begin receiving new therapy
8. Gene Therapy for HIV Inches Forward
9. Gino Tutera, M.D., F.A.C.O.G. Brings SottoPelle Therapy to Middle Tennessee, Opens Practice in Nashville Medical District
10. Combined BRAF-targeted and immunotherapy shows promise for melanoma treatment
11. Longer Antiviral Therapy Reduces Lung Transplant Complications
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/12/2017)... ... 12, 2017 , ... The American College of Medical Informatics (ACMI) will present ... the Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s Annual Symposium ... Collen, a pioneer in the field of medical informatics, this prestigious award is presented ...
(Date:10/12/2017)... ... October 12, 2017 , ... Dr. Parsa Mohebi, the ... medical article to the newly revamped Cosmetic Town journal section, featuring ... transplant procedure known as Follicular Unit Extraction (FUE). , Dr. Mohebi ...
(Date:10/12/2017)... Chapel, FL (PRWEB) , ... October 12, 2017 , ... ... is holding a treadmill relay – Miles by Moonlight to raise money for the ... donating $300 or more. , Teams will work together to keep their treadmills ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... ... of $3,296 in property taxes a year. In some states—like New York, New ... , By contrast, many overseas retirement havens have extremely low property-tax rates, which ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... Pepper Flow promotional review platform at the Promotional Review Committee Compliance and ... help marketers streamline the medical, legal, and regulatory review (MLR) process – ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... , Oct. 12, 2017   Divoti USA ... Jewelry up to the standard of the latest FDA requirements, which ... 2017). Anyone in need of Medical ID jewelry such ... Alert Jewelry are engraved in terms of the new ... Divoti offers ...
(Date:10/11/2017)... , Oct. 11, 2017  Caris Life Sciences ... on fulfilling the promise of precision medicine, today announced ... joined Caris, Precision Oncology Alliance™ (POA) as its 17 ... centers, the St. Jude Crosson Cancer Institute will help ... the use of tumor profiling, making cancer treatment more ...
(Date:10/10/2017)... Oct. 10, 2017  NDS received FDA 510(k) clearance in May ... battery-powered display stand specifically designed for endoscopy environments. An innovative secondary ... a clinical solution to support the improvement of patient outcomes, procedural ... ... ...
Breaking Medicine Technology: