LIMITATIONS Heterogeneity of organisms and dosing regimens studied prevent a species-specific treatment recommendation from being made .
CONCLUSIONS Preterm infants benefit from probiotics to prevent severe NEC and death
CONTEXT Necrotizing enterocolitis ( NEC ) is the most frequent gastrointestinal emergency in neonates .
The microbiome of the preterm gut may regulate the integrity of the intestinal mucosa .
Probiotics may positively contribute to mucosal integrity , potentially reducing the risk of NEC in neonates .
OBJECTIVE To perform an up date d systematic review and meta- analysis on the efficacy and safety of probiotics for the prevention of NEC in premature infants .
Probiotic Effects on Late-onset Sepsis in Very Preterm Infants: A Randomized Controlled Trial
BACKGROUND AND OBJECTIVE : Late-onset sepsis frequently complicates prematurity , contributing to morbidity and mortality . Probiotics may reduce mortality and necrotizing enterocolitis ( NEC ) in preterm infants , with unclear effect on late-onset sepsis . This study aim ed to determine the effect of administering a specific combination of probiotics to very preterm infants on culture-proven late-onset  sepsis . METHODS : A prospect i ve multicenter , double-blinded , placebo-controlled , r and omized trial compared daily administration of a probiotic combination ( Bifidobacterium infantis , Streptococcus thermophilus , and Bifidobacterium lactis , containing 1 × 109 total organisms ) with placebo ( maltodextrin ) in infants born before 32 completed weeks ’ gestation weighing < 1500 g. The primary outcome was at least 1 episode of definite late-onset sepsis . RESULTS : Between October 2007 and November 2011 , 1099 very preterm infants from Australia and New Zeal and were r and omized . Rates of definite late-onset sepsis ( 16.2 % ) , NEC of Bell stage 2 or more ( 4.4 % ) , and mortality ( 5.1 % ) were low in controls , with high breast milk feeding rates ( 96.9 % ) . No significant difference in definite late-onset sepsis or all-cause mortality was found , but this probiotic combination reduced NEC of Bell stage 2 or more ( 2.0 % versus 4.4 % ; relative risk 0.46 , 95 % confidence interval 0.23 to 0.93 , P = .03 ; number needed to treat 43 , 95 % confidence interval 23 to 333 ) . CONCLUSIONS : The probiotics B infantis , S thermophilus , and B lactis significantly reduced NEC of Bell stage 2 or more in very preterm infants , but not definite late-onset sepsis or mortality . Treatment with this combination of probiotics appears to be safe
LIMITATIONS Heterogeneity of organisms and dosing regimens studied prevent a species-specific treatment recommendation from being made .
CONCLUSIONS Preterm infants benefit from probiotics to prevent severe NEC and death
CONTEXT Necrotizing enterocolitis ( NEC ) is the most frequent gastrointestinal emergency in neonates .
The microbiome of the preterm gut may regulate the integrity of the intestinal mucosa .
Probiotics may positively contribute to mucosal integrity , potentially reducing the risk of NEC in neonates .
OBJECTIVE To perform an up date d systematic review and meta- analysis on the efficacy and safety of probiotics for the prevention of NEC in premature infants .