Effect of Addition of Probiotics to Standard Treatment on Neonatal Jaundice

Abstract

Objective: To compare the mean change in the bilirubin levels with addition of probiotics to standard treatment for the management of neonatal jaundice. Methodology: The randomized controlled trial was undertaken at the Neonatal Intensive Care Unit of the Paediatrics Department, Federal Government Polyclinic (Post Graduate Medical Institute), Islamabad from 1st April to 30th September 2019. Neonates with hyperbilirubinemia requiring phototherapy were randomly divided into two groups, each having 30 patients. Group A received probiotics along with phototherapy while group B received phototherapy alone. Primary outcome was serum total bilirubin, which was calculated on 0, 1 and 3 days of treatment. Duration of phototherapy and patient's outcome was also recorded. Data was analyzed statistically using SPSS v. 23. Results: The mean serum bilirubin level after 24 hours was 14.27 ± 4.35 mg/dl in combination group while 16.43 ± 4.36 mg/dl in phototherapy group (p > 0.05). After 48 hours, the mean serum bilirubin level was 12.37 ± 3.33 mg/dl in combination group while 14.09 ± 3.60 mg/dl in phototherapy group (p > 0.05). After 72 hours, the mean serum bilirubin level was 11.09 ± 2.87 mg/dl in combination group while 11.72 ± 2.96 mg/dl in phototherapy group (p > 0.05). The mean time required of blue light phototherapy was 43.47 ± 20.71 hours in combination group while 61.53 ±28.27 hours in phototherapy group (p < 0.05). All neonates were discharged. Conclusion: Addition of probiotics to standard treatment decreased the time required for the phototherapy in neonatal jaundice. However no statistically significant difference was seen in the bilirubin levels between the two groups.

Recent Advances in Adjuvant Pharmacotherapy for Neonatal Indirect Hyperbilirubinemia: A Narrative Review

“…Several trials have evaluated the effects of probiotics, prebiotics, and synbiotics in neonatal IHB adjunct to phototherapy. Walker-Pizarro et al, in an RCT on the efficacy of Lactobacillus reuteri and Saccharomyces boulardii in neonatal IHB, observed no statistical difference in bilirubin reduction rate consistent with the results of Afzal et al's study (25,26). In this regard, Santosa et al demonstrated no significant effects of probiotics on decreasing serum bilirubin levels (27).…”

Pengaruh Pemberian Probiotik terhadap Neonatus dengan Hiperbilirubinemia

“…Pada penelitian RCT yang dilakukan oleh Afzal et al 19 pada 60 neonatus hiperbilirubinemia dengan berat lebih dari 1,5 kg yang membutuhkan tatalaksana fototerapi pada 7 hari pertama kehidupan. Bayi-bayi tersebut dibagi dua menjadi kelompok intervensi yang menerima 2,5 ml Enterogermina ampule yang mengandung Bacillus clausii secara oral dan kelompok kontrol; kedua kelompok menerima tatalaksana fototerapi.…”