• Minmin Su, Ying Jia, Yan Li, Dianyou Zhou, and Jinsheng Jia.
• College of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, China.
• Respir Care. 2020 May 1; 65 (5): 673-685.

BackgroundVentilator-associated pneumonia (VAP) is a common and serious complication of mechanical ventilation. We conducted a meta-analysis of published randomized controlled trials to evaluate the efficacy and safety of probiotics for VAP prevention in patients who received mechanical ventilation.MethodsWe searched a number of medical literature databases to identify randomized controlled trials that compared probiotics with controls for VAP prevention. The results were expressed as odds ratios (OR) or mean differences with accompanying 95% CIs. Study-level data were pooled by using a random-effects model. Data syntheses were accomplished by using statistical software.ResultsFourteen studies that involved 1,975 subjects met our inclusion criteria. Probiotic administration was associated with a reduction in VAP incidence among all 13 studies included in the meta-analysis (OR 0.62, 95% CI 0.45-0.85; P = .003; I2 = 43%) but not among the 6 double-blinded studies (OR 0.72, 95% CI 0.44-1.19; P = .20; I2 = 55%). We found a shorter duration of antibiotic use for VAP (mean difference -1.44, 95% CI -2.88 to -0.01; P = .048, I2 = 30%) in the probiotics group than in the control group, and the finding comes from just 2 studies. No statistically significant differences were found between the groups in terms of ICU mortality (OR 0.95, 95% CI 0.67-1.34; P = .77; I2 = 0%), ICU stay (mean difference -0.77, 95% CI -2.58 to 1.04; P = .40; I2 = 43%), duration of mechanical ventilation (mean difference -0.91, 95% CI -2.20 to 0.38; P = .17; I2 = 25%), or occurrence of diarrhea (OR 0.72, 95% CI 0.45-1.15; P = .17; I2 = 41%).ConclusionsThe meta-analysis results indicated that the administration of probiotics significantly reduced the incidence of VAP. Furthermore, our findings need to be verified in large-scale, well-designed, randomized, multi-center trials.Copyright © 2020 by Daedalus Enterprises.

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