Skip to main content

Effect of probiotic containing lactobacillus, bifidobacterium and streptococcus thermophilus in critically ill patients


Sepsis is the most common cause of death in ICUs [1]. Destruction of intestinal barrier function and increased translocation of bacteria to systemic blood flow can lead to sepsis [2]. Probiotics may have beneficial effects in improvement of critically ill patients by modulating intestinal barrier and reduction of inflammation [3]. The aim of this trial was to determine the effect of probiotic on inflammatory biomarkers and mortality rate of sepsis in critically ill patients in the ICU.


This double-blind, randomized controlled trial was conducted on 40 critically ill patients admitted to the ICU. They were randomly assigned to receive placebo or probiotic for 7 days. The APACHE score, Sequential Organ Failure Assessment (SOFA) and systemic concentrations of IL-6, procalcitonin (PCT) and protein C were measured before initiation of the study and on days 4 and 7. Also, 28day mortality was evaluated for each patient.


IL-6 and PCT levels decreased and protein C levels increased significantly in probiotic group over the treatment period (P < 0.001). There was a significant difference in IL-6, PCT and protein C levels of the 7th day between two groups (P = 0.001, 0.006 and <0.001, respectively). Compared with controls, probiotic was effective in improving APACHE and SOFA scores in 7 days (P < 0.001). There was significant difference between the probiotic and control group in the 28-day mortality rate (20% vs. 55% respectively, P = 0.048).


Probiotics reduce inflammation and mortality rate in critically ill patients and might be considered as an adjunctive therapy to sepsis.


  1. 1.

    Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR: Epidemiology of severe sepsis in the USA: analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001, 29: 1303-1310. 10.1097/00003246-200107000-00002

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Hassoun HT, Kone BC, Mercer DW: Post-injury multiple organ failure: the role of gut. Shock 2001, 15: 1-10.

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Morrow LE: Probiotics in the intensive care unit. Curr Opin Crit Care 2009, 15: 144-148. 10.1097/MCC.0b013e3283252d2d

    Article  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to M Ebrahimi Mamaghani.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Mamaghani, M.E., Sanaie, S., Mahmoudpour, A. et al. Effect of probiotic containing lactobacillus, bifidobacterium and streptococcus thermophilus in critically ill patients. Crit Care 17, P246 (2013).

Download citation


  • Lactobacillus
  • Barrier Function
  • Sequential Organ Failure Assessment
  • Adjunctive Therapy
  • Systemic Blood