Oral Probiotic Containing Streptococcus salivarius K12 and Lactobacillus brevis CD2 for Preventing Bacterial Pneumonia in Severe COVID-19: Randomized Clinical Trial
Abstract
AIMS
To assess the effect of dental application of oral probiotics containing Streptococcus salivarius K12 and Lactobacillus brevis CD2 on preventing secondary bacterial pneumonia in patients with severe COVID-19.
MATERIALS AND METHODS
In this randomized, placebo-controlled trial, 60 patients with severe COVID-19 were randomly assigned to receive a 7-day course of oral gel containing S. salivarius K12 (2 billion colony-forming units) and L. brevis CD2 (4 billion colony-forming units) every 8 hours, or placebo, starting on the first intensive care unit (ICU) day. Gel applications were performed by a dentist. The primary outcome was bacterial pneumonia, whereas the secondary outcomes were survival and the 14-day illness-severity status.
RESULTS
Fifty patients completed the 7-day experiment. In which, 26 patients received probiotics (mean age: 58.7 years old, 81% men) and 24 patients received a placebo (60.5 years old, 71% men). The incidence of secondary bacterial pneumonia was 35% for probiotics and 54% for placebo [relative risk: 0.64 (95% CI: 0.34-1.22)]. Compared with placebo, patients treated with probiotics showed similar rates of ICU death [hazard ratio: 1.37 (95% CI: 0.56-3.35)]. The 14-day illness-severity status did not differ between groups.
CONCLUSION
In this phase II trial of patients with severe COVID-19, oral probiotics containing S. salivarius K12 and L. brevis CD2 did not prevent secondary bacterial pneumonia.
CLINICAL SIGNIFICANCE
Intensive care unit patients…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 60 participants or records.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Levofloxacin-Induced Tendon Rupture: A Case Report and Review of the Literature
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis
- Quality evaluation and in vitro interaction studies between levofloxacin 250mg and diclofenac sodium 50mg tablets
- Molecular Epidemiology of mcr-1 -Positive Polymyxin B-Resistant Escherichia coli Producing Extended-Spectrum β-Lactamase (ESBL) in a Tertiary Hospital in Shandong, China
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.