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Quality-improvement interventions have led to lower rates of ventilator-associated pneumonia (VAP) in many intensive care units (ICUs), but it remains a common nosocomial infection associated with prolonged length of stay. Studies have suggested that probiotics might be a helpful addition to other preventive strategies. An international team of investigators randomized 2650 patients from 44 ICUs who were receiving mechanical ventilation (and expected to require support for ≥72 hours) to receive enteral Lactobacillus rhamnosus GG or placebo twice daily. More than 80% of patients were receiving antibiotics at enrollment, including 60% of patients who were admitted with pneumonia. Diagnosis of VAP required a new, progressive, or persistent opa…