REVIEW ER 'S CONCLUSIONS Evidence suggests that oral antibiotics reduce the incidence of NEC in low birth weight infants .
BACKGROUND Necrotizing enterocolitis continues to be a problem , particularly in preterm neonates .
There have been reports published suggesting that the use of enteral antibiotics may be effective as prophylaxis .
This systematic review was undertaken to clarify the issue .
OBJECTIVES To evaluate the benefits and harms of enteral antibiotic prophylaxis for  necrotizing enterocolitis in low birth weight and preterm infants .
A randomized, controlled trial of parenteral clindamycin in neonatal necrotizing enterocolitis.
For an assessment of the efficacy of clindamycin in preventing bowel necrosis ( intestinal gangrene or perforation ) , 42 premature infants with radiographically confirmed necrotizing enterocolitis ( NEC ) ( pneumatosis , intraportal gas , or both ) were r and omly assigned to receive parenterally either ampicillin and gentamicin ( control group , n = 22 ) or ampicillin , gentamicin , and clindamycin ( n = 20 ) , 20 mg/kg/d at 8-hour intervals for 10 to 14 days . Infants who had received antibiotics for greater than 24 hours before r and omization and those developing intestinal gangrene or perforation less than 12 hours after r and omization were excluded .  Intestinal gangrene or perforation developed in four infants in the control group and six in the clindamycin group . Four in each group died of NEC . In the control group , one of 18 survivors developed a late stricture requiring surgical resection , whereas six of 15 survivors in the clindamycin group developed such strictures ( P = 0.022 ) . Routine inclusion of clindamycin in medical treatment of NEC does not reduce the frequency of intestinal gangrene or perforation and may be associated with an increase in late stricture formation
REVIEW ER 'S CONCLUSIONS Evidence suggests that oral antibiotics reduce the incidence of NEC in low birth weight infants .
BACKGROUND Necrotizing enterocolitis continues to be a problem , particularly in preterm neonates .
There have been reports published suggesting that the use of enteral antibiotics may be effective as prophylaxis .
This systematic review was undertaken to clarify the issue .
OBJECTIVES To evaluate the benefits and harms of enteral antibiotic prophylaxis for  necrotizing enterocolitis in low birth weight and preterm infants .