title: Use of probiotics to prevent ventilator-associated pneumonia: A survey of pharmacists' attitudes.
abstract: OBJECTIVE
  The primary objective of this survey was to describe pharmacists' attitudes regarding probiotic use in the intensive care unit (ICU); secondary objectives were to evaluate pharmacists' knowledge and use of probiotics for critically ill patients.
  
  
  METHODS
  The survey instrument was rigorously designed and pretested, then distributed in both English and French to Canadian ICU pharmacists. The online survey was open for 5 weeks, and 3 follow-up emails were sent to maximize response rates.
  
  
  RESULTS
  Of 303 eligible surveys, 191 were returned (63.0%). Probiotics were available in the hospitals of 69.8% (113/162) of respondents, and 62.0% (101/163) indicated that they had used probiotics for at least 1 ICU patient in the previous year. Most pharmacists (137/171, 80.1%) said that they would "never" consider recommending probiotics for prevention of ventilator-associated pneumonia in ICU patients, and this response was more common (P = .0074) among pharmacists who were "unsure" about the safety of probiotics in this population when compared to those who felt that they knew how safe probiotics are.
  
  
  CONCLUSIONS
  Most Canadian ICU pharmacists have used probiotics at least once in the ICU in the last year. However, based on uncertain efficacy and safety, most ICU pharmacists would not currently recommend probiotics for the prevention of ventilator-associated pneumonia.
authors.affiliation: Department of Pharmacy, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Wheeler
authors.affiliation: Departments of Medicine, Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Cook
authors.affiliation: Department of Medicine, Mount Sinai Hospital, Toronto, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Department of Pharmacy, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Adriana
authors.initials: A
authors.lastname: Calce
authors.affiliation: Department of Pharmacy, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Guenette
authors.affiliation: Department of Pharmacy, McGill University Health Center, Montreal, Canada.
authors.forename: Marc M
authors.initials: MM
authors.lastname: Perreault
authors.affiliation: Department of Pharmacy, Centre Hospitalier de l'Université de Montréal, Montreal, Canada.
authors.forename: Zoé
authors.initials: Z
authors.lastname: Thiboutot
authors.affiliation: Departments of Pediatrics and Clinical Epidemiology and Biostatistics, Hamilton Health Sciences, Hamilton, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Duffett
authors.affiliation: Department of Pharmacy, Mount Sinai Hospital, Toronto, Canada; Department of Medicine, Mount Sinai Hospital, Toronto, Canada. Electronic address: lburry@mtsinai.on.ca.
authors.forename: Lisa
authors.initials: L
authors.lastname: Burry
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D003422:Critical Care; D016638:Critical Illness; D006801:Humans; D007362:Intensive Care Units; D010595:Pharmacists; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D019936:Probiotics / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
keywords: Critical care; Pharmacists; Probiotics; Ventilator-associated pneumonia