Probiotics against infection trial begins

£1.8m project to explore probiotics’ ability to prevent infections and reduce antibiotic use in care home residents

The Centre for Trials Research at Cardiff, in partnership with Oxford University, is to embark on a £1.8m study to test whether a probiotic supplement can reduce the number of infections in care home residents - the aim is to cut antibiotic use in this high-risk group.

Probiotics are ‘good bacteria’ that can provide health benefits when taken as a supplement.

Infections are the most common reason for care home residents to be hospitalised, and previous research shows care home residents are disproportionately high users of antibiotics, which puts them at significant risk of developing antibiotic drug resistance.

This resistance can spread to hospitals and the community – reducing the effectiveness of these important drugs to fight common infections.

The researchers will recruit 330 care home residents in Cardiff and Oxford and provide them with daily supplements of the widely available probiotics Lactobacillus rhamnosus,and Bifidobacterium animalis subsp. lactis, versus a placebo, over a period of 12 months.

They will assess the total number of days on antibiotics for common infectious diseases, including flu-like illness, urinary tract infection, and skin and gastro-intestinal infections, in addition to their response to the influenza vaccine.

The project is funded by the Efficacy and Mechanism Evaluation (EME) Programme, a Medical Research Council (MRC) and National Institute for Health Research partnership.

Christopher Butler, a GP for the Cwm Taf University Health Board and Professor of Primary Care at the University of Oxford’s Nuffield Department of Primary Care Health Sciences, who will lead the research, said:

“The family doctor’s toolkit of useful and effective antibiotics to treat common infections is coming under threat from increasing drug resistance in our population.

“Care home residents are prescribed far more antibiotics than the general population since they are more vulnerable to infections due to their weakened immunity, close proximity living and multi-morbidity. They are often hospitalised when the drugs stop working.

“Other than vaccination and good hygiene, there are few proven ways to prevent infections in older care home residents - so probiotics represent an important target in efforts to combat antibiotic resistance. Our study should answer the question whether or not daily probiotics prevent infections.

“If successful, this cheap, safe probiotic could improve quality of life and contain antibiotic resistance in this growing vulnerable population, helping to preserve the effectiveness of our available antibiotic drugs into the future.”

Lactobacillus rhamnosus and Bifidobacterium animalis subsp. Lactis are live bacteria, and were chosen for this research because together they enhance immunity and may reduce the duration of common infectious diseases. However, there has been little research to date to support probiotic use in care home residents, and this study will fill that important gap.

The study is part of a larger investment of over £15.8m into research to tackle drug resistant infections, by the National Institute for Health Research (NIHR) - the research arm of the NHS.

Drug resistant infections present a major threat to the future of healthcare and by 2050 could result in 10 million avoidable deaths annually, from antibiotic resistant infections such as MRSA, sepsis and multi-drug-resistant mycobacterium tuberculosis.