REConstituting the microbiome After Pneumonia
Patients who are treated for pneumonia have a higher risk of re-admission in the following year. This may be in part due to a disturbance of the microbiota. Amsterdam UMC, location AMC, and WInclove propose to use probiotics to restore the microbiota to a more robust status in order to reduce hospital re-admissions in the year following a hospital treatment.
Community-acquired pneumonia (CAP) is the most important infection in terms of numbers of patients for which antibiotics are given in the hospital. Readmission and new infections in the year after hospital admission for pneumonia is frequent, varying from 15% up to 40% in certain subgroups. It is known that after a severe pneumonia and subsequent antibiotic treatment, the gut microbiome is severely perturbed. The intestinal microbiome plays an important role in the local and systemic immune system. Reconstitution of the severely perturbed microbiome after antibiotic treatment in patients with pneumonia could improve the immune status of patients and thereby ultimately lower readmission and infection rates.
In this pilot study we investigate whether a 90-day treatment with a selected probiotics-mixture can reconstitute the microbiome diversity after antibiotic treatment for CAP.
We will investigate this by analyzing the microbiome in combination with innate immune markers and clinical endpoints. Also, it will provide data on reinfection and readmission rates in this population. This pilot study could potentially pave the way for a larger clinical trial, aimed and powered to investigate preventive effects of probiotics on readmission and reinfection rates after hospital admission for CAP. This could pave the way to novel approaches to home care after hospitalization.
Despite the increased and extensive efforts of all our partners and the whole research team, the reality is that the inclusion-rate remained too low. After several meetings and careful consideration of the low inclusion rate, it was decided with all partners (TKI representative in the Amsterdam UMC, study team, Winclove Probiotics, DSMB, METC), that the study was to be ended prematurely due to unfeasibility. Seven participants have completely finished the study protocol. The study team will analyze these longitudinal samples, with the aim of publishing preliminary insights together with the unique design and premise of this study We will also share the many lessons learned during this project, which can have valuable and practical implications for future trials.
