Probiotic Therapy Prevents Pneumonia in Critically ill Patients

Kathleen Blanchard's picture

Researchers say probiotic therapy could prevent pneumonia in critically ill patients that can occur from mechanical ventilation. The condition, known as VAP or ventilator-associated pneumonia attacks critically ill patients and can result in death and prolonged hospital stays. Probiotic therapy reduced pneumonia by half in a small study.

The definition of VAP from the Centers for Disease Control is a "lung infection or pneumonia that develops in a person who is on a ventilator." Breathing tubes introduced through the trachea or through the mouth into the lungs can lead to ventilator-assisted pneumonia in 30 percent of patients who are critically ill.

Researchers, trying to find a novel way to keep patients safe from pneumonia, found that the probiotic Lactobacillus rhamnosus reduced ventilator associated pneumonia cases by half in patients treated twice a day.


According to Lee E. Morrow, M.D., M.Sc., associate professor of medicine at Creighton University and lead study author, "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."

The goal of the scientists was twofold: They wanted to prove the safety of probiotic therapy and they wanted to see if the therapy could really prevent disease. Dr. Morrow says, "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."

The study included 138 critically ill patients given Lactobacillus rhamnosus twice a day in the ICU. After 5 years the researchers found the 50 percent reduction in ventilator associated pneumonia compared to a patient group given placebo. They also noted that patients given probiotic therapy required fewer antibiotics and fewer infections from C. difficile that can typically result from using antibiotics.

Dr. Morrow says for $2.13 a day probiotic therapy could prevent ventilator associated pneumonia acquired by critically ill patients in the hospital. He also cautions that the findings are preliminary and should not be interpreted to mean all ICU patients should be given probiotics. He adds, "Ultimately, probiotics may fulfill a role in antimicrobial stewardship programs given the reductions in antibiotic consumption.", but larger controlled trials are needed with close patient monitoring.

Journal of Respiratory and Critical Care Medicine