Preventive Effect of Probiotics on Ventilator-Associated Pneumonia: A Meta-analysis of 2428 Patients.
Ann Pharmacother
; 55(8): 949-962, 2021 08.
Article
em En
| MEDLINE
| ID: mdl-33349001
ABSTRACT
BACKGROUND:
Researchers had contradictory conclusions about the role of probiotics in preventing ventilator-associated pneumonia (VAP), which has led to the controversial use of probiotics in mechanically ventilated patients.OBJECTIVE:
To explore the efficacy and safety of probiotics in preventing VAP.METHODS:
A literature search was conducted in 7 medical databases. Two investigators assessed literature quality independently and collected data. The primary outcome was the incidence of VAP. Secondary outcomes included 16 measures. Sensitivity analysis and subgroup and meta-regression analyses were performed to analyze the source of heterogeneity. P values <0.05 were considered statistically significant, and CIs were set at 95%. A random-effects model was set when I2 <50%, otherwise a fixed-effects model was used.RESULTS:
A total of 20 randomized controlled studies with a total of 2428 patients were analyzed. Pooled results showed positive effects of probiotics on the reduction of VAP incidence (risk ratio [RR] = 0.672; P < 0.001; I2 = 11.3%), length of ICU stay (WMD = -1.417; P = 0.012; I2 = 90.7%), oropharyngeal (RR = 0.866; P = 0.031; I2 = 12.4%) and gastric (RR = 0.645; P < 0.001; I2 = 30.2%) colonization. CONCLUSIONS AND RELEVANCE Probiotics can reduce the incidence of VAP and reduce oropharyngeal and gastric bacterial colonization. The results also suggest that probiotics do not cause adverse effects.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Probióticos
/
Pneumonia Associada à Ventilação Mecânica
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
China