Probiotics' effects on the incidence of nosocomial pneumonia in critically ill patients: a systematic review and meta-analysis.
Crit Care. 2012 Jun 25;16(3):R109
Authors: Liu KX, Zhu YG, Zhang J, Tao LL, Lee JW, Wang XD, Qu JM
ABSTRACT: INTRODUCTION: To evaluate the efficacy of probiotics in preventing nosocomial pneumonia in critically ill patients. METHODS: We searched PubMed, EMBASE, and the Web of Science for relevant studies. Two reviewers extracted data and reviewed the quality of the studies independently. The primary outcome was the incidence of nosocomial pneumonia. Study-level data were pooled using a random-effects model when I2 was > 50% or a fixed-effects model when I2 was < 50%. RESULTS: Twelve randomized controlled studies with a total of 1,546 patients were considered. Pooled analysis showed a statistically significant reduction in nosocomial pneumonia rates due to probiotics (OR = 0.75; 95% CI: 0.57-0.97; P=0.03; I2 = 46%). However, no statistically signicant difference was found between groups regarding in-hospital mortality (OR =0.93; 95% CI: 0.50-1.74; P=0.82; I2 = 51%), intensive care unit mortality (OR = 0.84; 95% CI: 0.55-1.29; P= 0.43; I2= 0%), duration of stay in the hospitals (MD in days = -0.13; 95% CI: -0.93-0.67; P = 0.75; I2 = 46%), or duration of stay in the intensive care units (MD in days = -0.72; 95% CI: -1.73- 0.29; P=0.16; I2= 68%). CONCLUSIONS: The use of probiotics was associated with a statistically significant reduction in the incidence of nosocomial pneumonia in critically ill patients. However, large, well-designed, randomized, multi-center trials are needed to confirm any effects of probiotics clinical endpoints such as mortality and length of ICU and hospital stay.
PMID: 22731894 [PubMed - as supplied by publisher]