Probiotics for prevention of necrotizing enterocolitis in preterm infants

AlFaleh, Khalid; Anabrees, Jasim

doi:10.1002/14651858.cd005496.pub4

Cited by 527 publications

(309 citation statements)

References 65 publications

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“…Several systematic reviews of randomized controlled trials (RCTs) on prophylactic probiotics for preterm infants have found beneficial effects on NEC and mortality [1,7]. Despite such favorable results, concerns about the effectiveness of prophylactic probiotics still remain.…”

Section: Introductionmentioning

confidence: 99%

Prophylactic Probiotics for Preterm Infants: A Systematic Review and Meta-Analysis of Observational Studies

Olsen

Greisen²,

Schrøder³

et al. 2015

Neonatology

115

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Background: Necrotizing enterocolitis (NEC) is a major morbidity and cause of mortality in preterm neonates. Probiotics seem to have a beneficial role in preventing NEC, which is confirmed in meta-analyses of randomized controlled trials (RCTs). We therefore aimed to review and confirm the efficacy of probiotics in preterm neonates obtained in observational studies. Objective: To assess the effects of prophylactic probiotics in preterm infants. Methods: A meta-analysis was performed searching PubMed, EMBASE, CENTRAL (the Cochrane Library) and www.clinicaltrials.gov. Reference lists of reviews of RCTs were also searched. Included studies were observational studies that enrolled preterm infants <37 weeks of gestational age. Trials were included if they administered any probiotics and measured at least one clinical outcome (e.g. NEC, all-cause mortality, sepsis or long-term development scores). Two authors extracted characteristics and outcomes from included studies. The Newcastle-Ottawa Scale was used for quality assessment. A random-effects meta-analysis model was used, and heterogeneity was assessed by the I² test. Results: We included 12 studies with 10,800 premature neonates (5,144 receiving prophylactic probiotics and 5,656 controls). The meta-analysis showed a significantly decreased incidence of NEC (risk ratio, RR = 0.55, 95% confidence interval, 95% CI, 0.39-0.78; p = 0.0006) and mortality (RR = 0.72, 95% CI, 0.61-0.85; p < 0.0001). Sepsis did not differ significantly between the two groups (RR = 0.86, 95% CI, 0.74-1.00; p = 0.05). Conclusions: Probiotic supplementation reduces the risk of NEC and mortality in preterm infants. The effect sizes are similar to findings in meta-analyses of RCTs. However, the optimal strain, dose and timing need further investigation.

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Section: Introductionmentioning

confidence: 99%

Prophylactic Probiotics for Preterm Infants: A Systematic Review and Meta-Analysis of Observational Studies

Olsen

Greisen²,

Schrøder³

et al. 2015

Neonatology

115

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“…thermophilus (2). All together results suggest that Lactobacilli play a major beneficial role in regard to a significant mortality rate associated with MODS (15). Beyond a lot of randomized trials on probiotics to prevent LOS there is still missing data regarding the optimal strain(s), dose, time to start and duration of probiotic therapy, as well as the taxonomy and quality of currently available probiotics formulations and products.…”

Section: Discussionmentioning

confidence: 99%

“…And probiotics as summarized recently in a systematic meta-analysis showed significant benefits on NEC rates and all-cause neonatal mortality (15).…”

Section: Introductionmentioning

confidence: 96%

Efficacy of a Triple Anti-Infective Regimen for Prevention of Complications in Critically Ill Term Neonates

2018

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“…and other bacteria used in probiotic supplements. A systematic review evaluating probiotics for the prevention of necrotising enterocolitis reported no cases of systemic infection caused by probiotic strains [4]. …”

Section: Discussionmentioning

confidence: 99%

<b><i>Lactobacillus</i></b> Sepsis following a Laparotomy in a Preterm Infant: A Note of Caution

et al. 2016

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Probiotics for preterm infants have been shown to reduce the incidence of necrotising enterocolitis and all-cause mortality in a recent meta-analysis. It has been argued, however, that some of these results may not be applicable to specific subgroups, e.g. infants with a birth weight of <1,000 g. The specific role of probiotics in improving health outcomes in preterm and term infants following intestinal surgery is not well defined. We report a case of a premature infant diagnosed with late-onset sepsis due to Lactobacillus rhamnosus following a laparotomy. We review pertinent published cases. This case highlights the importance of considering preterm infants as being at a higher risk of systemic probiotic infection following intestinal surgery.

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Probiotics for prevention of necrotizing enterocolitis in preterm infants

Cited by 527 publications

References 65 publications

Prophylactic Probiotics for Preterm Infants: A Systematic Review and Meta-Analysis of Observational Studies

Prophylactic Probiotics for Preterm Infants: A Systematic Review and Meta-Analysis of Observational Studies

Efficacy of a Triple Anti-Infective Regimen for Prevention of Complications in Critically Ill Term Neonates

<b><i>Lactobacillus</i></b> Sepsis following a Laparotomy in a Preterm Infant: A Note of Caution

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