A four-probiotic preparation for ventilator-associated pneumonia in multi-trauma patients: results of a randomized clinical trial
| Autor: | Vasilis Grosomanidis, George Stavrou, Maria Tsilika, Giannoula Thoma, Helen Massa, Giakoumis Mitos, Helen Mouloudi, A Voudouris, Niki Paraforou, Petra Malliou, Kyriaki Pagdatoglou, Kyriakos Fotiadis, Georgia Tsaousi, Ntina Kontopoulou, Spyridoula Vasiliagou, Evangelos J. Giamarellos-Bourboulis, E Antypa, Zoi Aidoni, Katerina Kotzampassi, Eleni Gkeka, Georgia Vasiliadou, Angeliki Chorti, Eleni Antoniadou |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty medicine.medical_treatment Enteral administration law.invention Sepsis Bifidobacterium animalis law Internal medicine medicine Humans Pharmacology (medical) Mechanical ventilation Greece biology business.industry Probiotics Ventilator-associated pneumonia Pneumonia Ventilator-Associated General Medicine Antibiotic Prophylaxis Middle Aged medicine.disease biology.organism_classification Intensive care unit Lactobacillus acidophilus Saccharomyces boulardii Regimen Pneumonia Infectious Diseases Female business Lactobacillus plantarum |
| Zdroj: | International Journal of Antimicrobial Agents. 59:106471 |
| ISSN: | 0924-8579 |
| Popis: | The role of probiotics in the prevention of ventilator-associated pneumonia (VAP) remains inconclusive. The aim of this study was to assess the efficacy of a probiotic regimen for VAP prophylaxis in mechanically ventilated multi-trauma patients, intubated immediately after the injurious insult. In a randomized, placebo-controlled study enrolling multi-trauma patients, patients expected to require mechanical ventilation for >10 days were assigned at random to receive prophylaxis with a probiotic formula (n=59) or placebo (n=53). The probiotic formula was a preparation of Lactobacillus acidophilus LA-5 [1.75 × 109 colony-forming units (cfu)], Lactobacillus plantarum (0.5 × 109 cfu), Bifidobacterium lactis BB-12 (1.75 × 109 cfu) and Saccharomyces boulardii (1.5 × 109 cfu) in sachets. Each patient received two sachets twice daily for 15 days: one through the nasogastric tube and one spread on the oropharynx. The incidence of VAP was the primary endpoint. The incidence of other infections and sepsis, and the duration of hospital stay were the secondary endpoints. Administration of probiotics reduced the incidence of VAP [11.9% vs 28.3%, hazard ratio (HR) 0.34, 95% confidence interval (CI) 0.13–0.92; P=0.034] and sepsis [6.8% vs 24.5%, odds ratio 0.22, 95% CI 0.07–0.74: P=0.016]. Furthermore, probiotic prophylaxis reduced the time of stay in the intensive care unit (ICU) and the length of hospital stay. The prophylactic use of probiotics with a combination of enteral and topical application to the oropharynx had a positive effect on the incidence of VAP and sepsis, as well as on ICU and total hospital stay in patients receiving protracted mechanical ventilation. |
| Databáze: | OpenAIRE |
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