Abstract | BACKGROUND: DESIGN: METHODS: PubMed, Scopus, Current Contents, Cochrane Central Register of Controlled Trials, and reference lists were searched. Weighted mean differences, pooled odds ratios, and 95% confidence intervals were calculated, implementing both the Mantel-Haenszel fixed effect and the DerSimonian-Laird random effects model. RESULTS: Five randomized controlled trials were included. Administration of probiotics, compared with control, was beneficial in terms of incidence of ventilator-associated pneumonia (689 patients; fixed effect model: odds ratio, 0.61; 95% confidence interval, 0.41-0.91; random effects model: odds ratio, 0.55, 95% confidence interval, 0.31-0.98), length of intensive care unit stay (fixed effect model: weighted mean difference, -0.99 days; 95% confidence interval, -1.37--0.61), and colonization of the respiratory tract with Pseudomonas aeruginosa (odds ratio, 0.35; 95% confidence interval, 0.13-0.93). However, no difference was revealed between comparators regarding intensive care unit mortality (odds ratio, 0.75; 95% confidence interval, 0.47-1.21), in-hospital mortality (odds ratio, 0.75; 95% confidence interval, 0.46-1.24), duration of mechanical ventilation (weighted mean difference, -0.01 days; 95% confidence interval, -0.31--0.29), and diarrhea (odds ratio, 0.61; 95% confidence interval, 0.28-1.34). CONCLUSION: Administration of probiotics is associated with lower incidence of ventilator-associated pneumonia than control. Given the increasing antimicrobial resistance, this promising strategy deserves consideration in future studies, which should have active surveillance for probiotic-induced diseases.
|
Authors | Ilias I Siempos, Theodora K Ntaidou, Matthew E Falagas |
Journal | Critical care medicine
(Crit Care Med)
Vol. 38
Issue 3
Pg. 954-62
(Mar 2010)
ISSN: 1530-0293 [Electronic] United States |
PMID | 20016381
(Publication Type: Journal Article, Meta-Analysis)
|
Topics |
- Critical Care
- Hospital Mortality
- Humans
- Pneumonia, Ventilator-Associated
(mortality, prevention & control)
- Probiotics
(administration & dosage)
- Pseudomonas Infections
(mortality, prevention & control)
- Pseudomonas aeruginosa
- Randomized Controlled Trials as Topic
|