PROSPECT: Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial
The PROSPECT Trial is key to the ongoing search for more effective strategies to prevent serious infection during critical illness in elderly patients around the world.
Possible Research Results
Anticipated Findings: Probiotics may prevent ventilator-associated pneumonia (VAP), decrease other ICU-acquired infections such as Clostridium difficile infection (CDI) and antibiotic-associated diarrhea, and reduce overall antibiotic use, particularly in older adults living with frailty.
Impact of Findings: Preventing VAP is a patient safety priority due to the high risk of death and health care costs. Thus, there is great interest in effective prevention strategies that lower infection rates; as they will also reduce antimicrobial use, and thus antimicrobial resistance.
About the Project
Probiotics are defined as live bacteria thought to have health benefits when taken by mouth. Studies in the intensive care unit (ICU) found that patients who receive probiotics experience a 25% reduction in lung infection, known as ventilator‐associated pneumonia (VAP), and 18% reduction in the chance of developing any infection in the ICU. Although probiotics also seem to reduce antibiotic associated diarrhea and Clostridium difficile infections, this has not been properly evaluated. Elderly patients are at particularly high risk for infections due to their aging immune system.
Despite the use of advanced technology, critically ill older adults living with frailty typically have poor outcomes following their ICU admission. Previous research with family members, the Canadian Critical Care Trials Group and other partners affirm that if available, inexpensive interventions that decrease risk of infection during critical illness will be readily used for frail older patients.
VAP prevention is a major focus of the national quality improvement campaign (Safer Healthcare Now!), Accreditation Canada and the Canadian Patient Safety Institute, which aim to reduce world-wide concerns of antimicrobial resistance and hospital‐acquired infections. PROSPECT results will be incorporated into guidelines to inform global practice. Probiotics may be an easy‐to‐use, readily available, inexpensive approach to help reduce serious infections in older critically ill patients.
For more details on the project rationale, hypothesis, objectives and research plan, click here
Deborah Cook, MD, MSc (Epid), FRCPC, DABIM, CCM, CAHS, FRS -- McMaster University
Ian Ball, MD -- Western University
Emmanuel Charbonney, MD -- Université de Montréal
Laurence Chau, MD -- Oakville Trafalger Hospital
Robert Cirone, MD -- St. Joseph's Health Centre
Peter Dodek, MD -- University of British Columbia
Martin Girard, MD -- Université de Montréal
Eyal Golan, MD -- University of Toronto
Rick Hall, MD -- Dalhousie University
William Henderson, MD -- University of British Columbia
Margaret Herridge, MD -- University of Toronto
Jennie Johnstone, MD -- Dalla Lana School of Public Health, University of Toronto/Public Health Ontario
Tim Karachi, MD -- McMaster University
Kosar Khwaja, MD -- McGill University
Arnie Kristof, MD -- McGill University
Jim Kutsiogianis, MD -- University of Alberta
François Lamontagne, MD -- Université de Sherbrooke
François Lauzier, MD -- Université Laval
John Marshall, MD -- University of Toronto
Lauralyn McIntyre, MD -- University of Ottawa
Maureen Meade, MD -- McGill University
Sangeeta Mehta, MD -- University of Toronto
Andrew Morris, MD -- University of Toronto
Daniel Ovakim, MD -- University of British Columbia
Joe Pagliarello, MD -- University of Ottawa
Brenda Reeve, MD -- Brantford General Hospital
Bram Rochwerg, MD -- McMaster University
Lehana Thabane, PhD -- McMaster University
Gordon Wood, MD -- University of British Columbia
Ryan Zarychanski, MD -- University of Manitoba/CancerCare Manitoba
Project Contact: Dr. Deborah Cook -- email@example.com
Key words: probiotics, critically ill, randomized controlled trial, pneumonia, infection, clostridium difficile, diarrhea, intensive care unit, frailty