Probiotic therapy may cut VAP risk of patients in ICU: Study
Last Updated: Thursday, June 17, 2010, 00:00
  

Washington: Regular use of probiotics, or
live microorganisms, may reduce by almost half the risk of
ventilator-associated pneumonia (VAP) that complicates
treatment of about 30 per cent of critically ill patients
under mechanical ventilation care, a new research has claimed.



The study by researchers from Creighton University
School of Medicine in Omaha, Nebraska, found that daily use of
probiotics not only decreased VAP infections by about 50 per
cent, but also reduced the amount of antibiotics needed.

VAP is a kind of hospital-acquired pneumonia that occurs
in people who are on mechanical ventilation through an
endotracheal or tracheostomy tube for at least 48 hours. It is
estimated that VAP complicates the care of up to 30 per cent
of critical care patients receiving mechanical ventilation.



According to the researchers, whose findings appeared in
the American Thoracic Society`s website, patients with VAP
have increased mortality rate and they need prolonged stay in
intensive care unit (ICU), doubling the hospital costs.



Lead author Lee E Morrow said: "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.



"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.



For their study, Dr Morrow and colleagues included 138
critically ill patients from a single centre to receive either
placebo or probiotic therapy. Patients in the treatment arm
received specific units of Lactobacillus rhamnosus, a
probiotic bacterium, twice a day.



After almost five years, the researchers found that
daily use of probiotics not only decreased VAP infections by
about 50 per cent 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 -- which
causes diarrhea and other intestinal disease -- in patients
given probiotics. No side effects attributable to the
probiotics were observed.



"Collectively, these data suggest that Lactobacillus may
represent a novel, inexpensive and non-antibiotic approach to
prevention of nosocomial infections in properly selected ICU
patients," said Dr Morrow.



However, he said their 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 emphasise that these data should be viewed
as preliminary in nature and cannot be generalised to the
general ICU population ..."



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



PTI


First Published: Thursday, June 17, 2010, 00:00



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