When children are critically ill in intensive care units, they often need strong antibiotics to fight infections. However, these medications can have a side effect: they can disrupt the gut microbiota, which is the community of healthy bacteria living in the digestive system. This disruption is a major factor that doctors can try to manage.
Research shows that specific antibiotics, such as piperacillin-tazobactam, meropenem, and clindamycin, cause significant damage to these healthy gut microbes. When this balance is lost, children face a higher risk of developing Clostridioides difficile infections and ventilator-associated pneumonia. Specifically, exposure to carbapenems was linked to an increased risk of pneumonia.
While some evidence suggests that probiotics might reduce pneumonia cases and shorten stays in the intensive care unit, they should not be used routinely for high-risk children. Instead, the first line of defense is careful antibiotic stewardship to protect the gut. Because there is currently a lack of specific trial data for other treatments like postbiotics, careful management of antibiotics remains the primary strategy.
