Prebiotic Inulin to Limit Antimicrobial-Resistant Infections During Critical Illness: A Phase II Clinical Trial
Abstract
Antibiotic resistance is an emerging healthcare crisis and critically ill patients are among the hardest hit; over half of all infections in intensive care unit (ICU) patients are due to multi-drug resistant (MDR) bacteria, and systemic infection with these bacteria significantly increases risk of death. Active duty military personnel are particularly susceptible to acquisition of MDR organisms due to traumatic injury and because they work in regions where the prevalence of antimicrobial resistance is high. The normal commensal gut bacteria protect against MDR organism (MDRO) colonization, but these protective bacteria are typically lost in the ICU as a result of antibiotics and other interventions. The proposed research hypothesizes that treatments aimed at preserving the gut bacteria that ferment fiber into short-chain fatty acids (SCFAs) will limit the proliferation of antimicrobial resistance within the gut bacteria and ultimately prevent infections with MDROs. Specifically, we will test inulin, a prebiotic fiber made from root vegetables that is the preferred nutrient source for SCFA-producing bacteria. 90 ICU patients will be randomized 1:1:1 to receive placebo or one of two inulin doses for 7 days. The overall aims of the trial are to assess the safety and feasibility of inulin administration in the ICU patients, and its ability to limit the proliferation of antibiotic resistant MDROs.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 01, 2021
- Accession Number
- AD1148038
Entities
People
- Anne-Catrin Uhlemann
- Daniel E Freedberg
- Elissa Lynch
- Julian Abrams
Organizations
- Columbia University