Evidence of low quality suggests that lactoferrin supplementation to enteral feeds with or without probiotics decreases late-onset sepsis and NEC stage II or III in preterm infants without adverse effects .
BACKGROUND Lactoferrin , a normal component of human colostrum and milk , can enhance host defenses and may be effective for prevention of sepsis and necrotizing enterocolitis ( NEC ) in preterm neonates .
To assess the safety and effectiveness of lactoferrin supplementation to enteral feeds for prevention of sepsis and NEC in preterm neonates Secondary objectives 1 .
To determine the effects of lactoferrin supplementation to enteral feeds to prevent neonatal sepsis and /or NEC on duration of positive-pressure ventilation , development of chronic lung disease ( CLD ) or periventricular leukomalacia ( PVL ) , length of hospital stay to discharge among survivors , and adverse neurological outcomes at two years of age or later2 .
To determine the adverse effects of lactoferrin supplementation for prophylaxis of neonatal sepsis and /or NECWhen data were available , we analyzed the following subgroups.1 .
Gestational age < 32 weeks and 32 to 36 weeks2 .
Type of feeding : breast milk versus formula milk SEARCH METHODS : We used the search strategy of the Cochrane Neonatal Review Group ( CNRG ) to up date our search in December 2016 .
Prophylaxis with lactoferrin, a novel antimicrobial agent, in a neonatal rat model of coinfection
Lactoferrin has broad-spectrum antimicrobial activity , and the authors hypothesized that recombinant human lactoferrin ( Talactoferrin alfa [ TLF ] ) would reduce mortality and morbidity in a coinfection model . The MIC50 ( minimum inhibitory concentration required to inhibit the growth of 50 % of organisms ) of TLF againstC and ida albicans and Staphylococcus epidermidis was determined . Neonatal Wistar rats were infected withCalbicans orS epidermidis or both , at doses of 2 × 108 colony-forming units ( CFUs ) given subcutaneously . Rat pups in each group were r and omly given TLF intraperitoneally at 40 mg/kg/dose or 300 mg/kg/dose , or saline in 0.2 mL , once a day for 4 d and were monitored for mortality , weight gain , and blood culture positivity . Trough serum levels of TLF were measured at 24 , 48 , 72 , 96 , and 144 h. MIC50 of TLF was 30 μg/mL and 500 μg/mL forC albicans and Sepidermidis , respectively . TLF prophylaxis significantly improved survival in the coinfection group at 40 mg/kg/dose ( by 16.1 % ; P=.019 ) and at 300 mg/kg/dose ( by 15.1 % ; P=.027 ) and in the Sepidermidis group at a dose of 40 mg/kg/dose ( by 1 8.6 % ; P=.04 ) . Weight gain was not affected by TLF prophylaxis . Serum trough levels of TLF were 1000-fold lower than in vitro MIC50 . The authors conclude that lactoferrin prophylaxis significantly enhanced survival in coinfection and in the subgroupof S epidermidis infection ( 40 mg/kg/dose ) through indirect mechanisms
Evidence of low quality suggests that lactoferrin supplementation to enteral feeds with or without probiotics decreases late-onset sepsis and NEC stage II or III in preterm infants without adverse effects .
BACKGROUND Lactoferrin , a normal component of human colostrum and milk , can enhance host defenses and may be effective for prevention of sepsis and necrotizing enterocolitis ( NEC ) in preterm neonates .
To assess the safety and effectiveness of lactoferrin supplementation to enteral feeds for prevention of sepsis and NEC in preterm neonates Secondary objectives 1 .
To determine the effects of lactoferrin supplementation to enteral feeds to prevent neonatal sepsis and /or NEC on duration of positive-pressure ventilation , development of chronic lung disease ( CLD ) or periventricular leukomalacia ( PVL ) , length of hospital stay to discharge among survivors , and adverse neurological outcomes at two years of age or later2 .
To determine the adverse effects of lactoferrin supplementation for prophylaxis of neonatal sepsis and /or NECWhen data were available , we analyzed the following subgroups.1 .
Gestational age < 32 weeks and 32 to 36 weeks2 .
Type of feeding : breast milk versus formula milk SEARCH METHODS : We used the search strategy of the Cochrane Neonatal Review Group ( CNRG ) to up date our search in December 2016 .