Enteral supplementation of probiotics prevents severe NEC and all cause mortality in preterm infants .
There is insufficient data with regard to the benefits and potential adverse effects in the most at risk infants weighing less than 1000 grams at birth
BACKGROUND Necrotizing enterocolitis ( NEC ) and nosocomial sepsis are associated with increased morbidity and mortality in preterm infants .
Through prevention of bacterial migration across the mucosa , competitive exclusion of pathogenic bacteria , and enhancing the immune responses of the host , prophylactic enteral probiotics ( live microbial supplements ) may play a role in reducing NEC and the associated morbidity .
OBJECTIVES To compare the efficacy and safety of prophylactic enteral probiotics administration versus placebo or no treatment in the prevention of severe NEC or sepsis , or both , in preterm infants .
PLAIN LANGUAGE SUMMARY Probiotics for prevention of necrotizing enterocolitis in preterm infants Necrotizing enterocolitis ( NEC ) is a serious disease that affects the bowel of premature infants in the first few weeks of life .
Although the cause of NEC is not entirely known , milk feeding and bacterial growth play a role .
Probiotics ( dietary supplements containing potentially beneficial bacteria or yeast ) have been used to prevent NEC .
Effects of Oral Lactobacillus GG on Enteric Microflora in Low-Birth-Weight Neonates
Background Colonization patterns , especially by anaerobic flora , may play an important role in neonatal gut function . Probiotics could affect disease risk either directly through colonization or indirectly by promoting changes in gut microbial ecology . Methods To study the ability of Lactobacillus GG ( LGG ) to colonize the neonatal gut and modify its microbial ecology , a prospect i ve , r and omized study was performed in 71 preterm infants of less than 2000 g birth weight . Infants less than 1500 g ( 24 treated , 15 control ) received 109 LGG orally twice daily for 21 days . Those infants weighing 1500 to 1999 g ( 23 treated , 9 control ) were treated for 8 days . Stools were collected before treatment and on day 7 to 8 ( and day 14 and 21 , in the infants weighing less than 1500 g ) for quantitative aerobic and anaerobic cultures . Results Colonization with LGG occurred in 5 of 24 ( 21 % ) infants who weighed less than 1500 g versus 11 of 23 ( 47 % ) in larger infants . Colonization was limited to infants who were not on antibiotics within 7 days of treatment with LGG . There was a paucity of bacterial species at baseline , although larger infants had more bacterial species ( 1.59 ± 0.13 ( SEM ) vs 1.11 ± 0.12;P < 0.03 ) and higher mean log colony forming units ( CFU ) ( 8.79 ± 0.43 vs 7.22 ± 0.63;P < 0.05 ) compared with infants weighing less than 1500 g LGG . Treatment in infants weighing less than 1500 g result ed in a significant increase in species number by day 7 , with further increases by day 21 . This increase was mainly the result of increased Gram ( + ) and anaerobic species . No difference in species number was noted in controls . Mean log CFU of Gram ( − ) bacteria did not change in treated infants weighing less than 1500 g. However , Gram ( + ) mean log CFU showed a significant increase on day 21 ( 6.1 ± 0.9 ) compared with day 0 ( 3.5 ± 0.9 ) ( P < 0.05 ) . No significant changes in species number or quantitative counts were noted after LGG treatment in the infants weighing 1500 to 1999 g LGG was well tolerated in all infants . Conclusion The neonatal response to a probiotic preparation is dependent on gestational and post-natal age and prior antibiotic exposure . Although LGG is a relatively poor colonizer in infants , especially those infants weighing less than 1500 g at birth , it does appear to affect neonatal intestinal colonization patterns
Enteral supplementation of probiotics prevents severe NEC and all cause mortality in preterm infants .
There is insufficient data with regard to the benefits and potential adverse effects in the most at risk infants weighing less than 1000 grams at birth
BACKGROUND Necrotizing enterocolitis ( NEC ) and nosocomial sepsis are associated with increased morbidity and mortality in preterm infants .
Through prevention of bacterial migration across the mucosa , competitive exclusion of pathogenic bacteria , and enhancing the immune responses of the host , prophylactic enteral probiotics ( live microbial supplements ) may play a role in reducing NEC and the associated morbidity .
OBJECTIVES To compare the efficacy and safety of prophylactic enteral probiotics administration versus placebo or no treatment in the prevention of severe NEC or sepsis , or both , in preterm infants .
PLAIN LANGUAGE SUMMARY Probiotics for prevention of necrotizing enterocolitis in preterm infants Necrotizing enterocolitis ( NEC ) is a serious disease that affects the bowel of premature infants in the first few weeks of life .
Although the cause of NEC is not entirely known , milk feeding and bacterial growth play a role .
Probiotics ( dietary supplements containing potentially beneficial bacteria or yeast ) have been used to prevent NEC .