Objectives: To determine the effects of routine probiotics on necrotizing enterocolitis (NEC) rates in a large tertiary Australian neonatal unit.Methods: Retrospective cohort study of infants born < 32 weeks of gestation between 1 st of November 2011 and 31 st of October 2013. Data were collected over two periods, before and after introduction of probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum). A subgroup analysis was carried out for extremely low birth weight (ELBW) infants. Confirmed NEC was defined as stage II or more as per modified Bell's criteria. T-tests or Wilcoxon Tests were used to compare continuous variables and Chi-square or Fisher's exact test to compare categorical variables. Logistic regression was used to assess perinatal variables that might influence the risk of NEC.Results: 297 untreated infants were compared with 283 infants who received probiotic prophylaxis. The incidence of NEC was significantly lower with probiotic treatment (4.4 versus 1.1%, p-value 0.02). The effect was more pronounced in ELBW infants, 11 of 89 untreated infants developed confirmed NEC versus 2 of 98 exposed infants (12.4% versus 2%, p-value 0.008). There were no episodes of sepsis with the administered probiotic species.Conclusions: Prophylactic therapy with L. acidophilus and B. bifidum resulted in a statistically significant benefit. In ELBW infants, the number needed to treat to prevent one case of NEC was 10.
Objectives: To determine the effects of routine probiotics on necrotizing enterocolitis (NEC) rates in a large tertiary Australian neonatal unit.Methods: Retrospective cohort study of infants born < 32 weeks of gestation between 1 st of November 2011 and 31 st of October 2013. Data were collected over two periods, before and after introduction of probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum). A subgroup analysis was carried out for extremely low birth weight (ELBW) infants. Confirmed NEC was defined as stage II or more as per modified Bell's criteria. T-tests or Wilcoxon Tests were used to compare continuous variables and Chi-square or Fisher's exact test to compare categorical variables. Logistic regression was used to assess perinatal variables that might influence the risk of NEC.Results: 297 untreated infants were compared with 283 infants who received probiotic prophylaxis. The incidence of NEC was significantly lower with probiotic treatment (4.4 versus 1.1%, p-value 0.02). The effect was more pronounced in ELBW infants, 11 of 89 untreated infants developed confirmed NEC versus 2 of 98 exposed infants (12.4% versus 2%, p-value 0.008). There were no episodes of sepsis with the administered probiotic species.Conclusions: Prophylactic therapy with L. acidophilus and B. bifidum resulted in a statistically significant benefit. In ELBW infants, the number needed to treat to prevent one case of NEC was 10.
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