Early and sustained Lactobacillus plantarum probiotic therapy in critical illness: The randomised, placebo-controlled, restoration of gut microflora in critical illness trial (ROCIT)

Abstract

© 2021, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: In adults requiring treatment in an intensive care unit, probiotic therapy using Lactobacillus plantarum 299v may reduce nosocomial infection. The aim of this study was to determine whether early and sustained L. plantarum 299v therapy administered to adult ICU patients increased days alive and at home. Methods: A multicentre, parallel group, placebo-controlled, randomised clinical trial was conducted. Adult patients within 48 h of intensive care admission and expected to require intensive care beyond the day after recruitment were eligible to participate. L plantarum 299v or placebo were administered immediately after enrolment and continued for 60 days. The primary outcome was days alive and out of hospital to Day 60 (DAOH60). Secondary outcomes included nosocomial infections. Results: The median [interquartile range (IQR)] number of DAOH60 in the probiotic (n = 110) and placebo group (n = 108) was 49.5 (IQR 37.0–53.0) and 49.0 (IQR 43.8–53.0) respectively, between-group difference of 0.0 [95% confidence interval (CI) − 6.10 to 7.1, P = 0.55]. Nosocomial infection occurred in 8 (7.3%) and 5 (4.6%) of the probiotic and placebo group participants, respectively, odds ratio 1.62 (95% CI 0.51–5.10), P = 0.57. There were no serious, or probiotic-associated adverse events. Conclusion: Early and sustained untargeted administration of probiotic therapy with Lactobacillus plantarum 299v to adult patients admitted to the ICU is safe, but not associated with improved patient outcomes.

Keywords

Critical illness, Intensive care unit, Nosocomial infection, Probiotics

Document Type

Journal Article

Date of Publication

2021

Publication Title

Intensive Care Medicine

Publisher

Springer

School

School of Science / Centre for Integrative Metabolomics and Computational Biology

RAS ID

32925

Funders

Department of Health Government of Western Australia Research Translation Projects St John of God Hospital Foundation Fiona Wood Foundation Fiona Stanley Fremantle Hospital Group

Comments

Litton, E., Anstey, M., Broadhurst, D., Chapman, A., Currie, A., Ferrier, J., ... Wood, F. (2021). Early and sustained Lactobacillus plantarum probiotic therapy in critical illness: The randomised, placebo-controlled, restoration of gut microflora in critical illness trial (ROCIT). Intensive Care Medicine, 47(3), 307-315. https://doi.org/10.1007/s00134-020-06322-w

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10.1007/s00134-020-06322-w