Changes of Oropharyngeal Flora

NCT ID: NCT02303301

Last Updated: 2020-10-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

145 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-10-31

Study Completion Date

2020-07-31

Brief Summary

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Hospitalised patients have in contrast to healthy people enteric pathogenic bacteria in their oropharynx Increased risk of pneumonia due to the pathogens in the oropharynx Probiotics can reduce such bacteria in intubated critically ill patients This study will use two strain of probiotic bacteria for half of the patients and a placebo for the rest Active arm gurgles with a suspension twice a day Cultures at inclusion and at set time intervals The results of cultures from the two groups will be compared as will the use of antibiotics

Detailed Description

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When patients are admitted to hospital some of them are already colonized in the oropharynx with pathogens that are normally found as commensal or possible pathogens in the gastrointestinal tract. This is probably a consequence of the illness that is the cause of their hospital admission.

Most patients admitted to hospital are elderly. Those patients often have their natural functions down regulated including their ability to secure their airway from aspiration. Acute illness whether you are old or young leads to changes in the intestinal microbiological flora. Bacteria normally found in the colon or distal ileum frequently appear in the stomach and more alarming in the oropharynx. Weakened by the illness, acute or chronic, there is an increased risk of aspiration and when there are pathogenic bacteria in the oropharynx, aspiration is likely to induce pneumonia - health related pneumonia.

For intubated ICU patients we have demonstrated a reduction of colonization with enteric bacteria by applying probiotics in the mouth.

After a screening period to find out what groups of patients that are most vulnerable, we will in a randomised way give probiotics to half of the included patients and to the other patients only the filling material (maltodextrin).

With this procedure our aim is to show a reduction of pathogens in the oropharynx and as a secondary outcome we hope to see a reduction of pneumonia.

Samples for microbiological analysis will be taken during the first day of admission to hospital and then at specified intervals.

Conditions

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Pharyngeal Bacterial Colonization Pneumonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Probiotics

Patients gurgle twice a day with a suspension of two probiotic strains of bacteria- Contains also a filling material - maltodextrin

Group Type ACTIVE_COMPARATOR

Probiotics

Intervention Type DIETARY_SUPPLEMENT

Cultures from the oropharynx

Control

Patients gurgle twice a day with a suspension of the filling material - maltodextrin

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DIETARY_SUPPLEMENT

Cultures from the oropharynx

Interventions

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Probiotics

Cultures from the oropharynx

Intervention Type DIETARY_SUPPLEMENT

Placebo

Cultures from the oropharynx

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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ProViva (Lactobacillus plantarum 299v) Maltodextrin

Eligibility Criteria

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Inclusion Criteria

* Admitted to hospital
* Anticipated length of hospital stay 3 days or more

Exclusion Criteria

* Immune insufficiency
* Prior participation in the study
* Not being able to understand study information
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Probi AB

INDUSTRY

Sponsor Role collaborator

Region Skane

OTHER

Sponsor Role lead

Responsible Party

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Bengt Klarin

MD Consultant

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bengt Klarin, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Lund University Hospital

Locations

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Lund University Hospital

Lund, , Sweden

Site Status

Countries

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Sweden

References

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Johanson WG, Pierce AK, Sanford JP. Changing pharyngeal bacterial flora of hospitalized patients. Emergence of gram-negative bacilli. N Engl J Med. 1969 Nov 20;281(21):1137-40. doi: 10.1056/NEJM196911202812101. No abstract available.

Reference Type BACKGROUND
PMID: 4899868 (View on PubMed)

Klarin B, Molin G, Jeppsson B, Larsson A. Use of the probiotic Lactobacillus plantarum 299 to reduce pathogenic bacteria in the oropharynx of intubated patients: a randomised controlled open pilot study. Crit Care. 2008;12(6):R136. doi: 10.1186/cc7109. Epub 2008 Nov 6.

Reference Type RESULT
PMID: 18990201 (View on PubMed)

Tranberg A, Klarin B, Johansson J, Pahlman LI. Efficacy of Lactiplantibacillus plantarum 299 and 299v against nosocomial oropharyngeal pathogens in vitro and as an oral prophylactic treatment in a randomized, controlled clinical trial. Microbiologyopen. 2021 Jan;10(1):e1151. doi: 10.1002/mbo3.1151. Epub 2020 Dec 22.

Reference Type DERIVED
PMID: 33350604 (View on PubMed)

Related Links

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http://www.probi.se

Producers of the study products

Other Identifiers

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ProOro

Identifier Type: -

Identifier Source: org_study_id

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