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Should the use of probiotics in the preterm be routine?

Michael Millar1, Mark Wilks, Paul Fleming

  • 1Department of Infection, Barts and The London NHS Trust, 80 Newark St, Whitechapel, London, UK. m.r.millar@qmul.ac.uk

Archives of Disease in Childhood. Fetal and Neonatal Edition
|September 28, 2010
PubMed

Insights

Clinical trials do not yet justify routine probiotic use in preterm infants due to uncertainties in efficacy, safety, and long-term outcomes. A precautionary approach is recommended before widespread adoption in neonatal care.

Area of Science:

  • Neonatal Medicine
  • Microbiology
  • Clinical Trials

Background:

  • Probiotics are increasingly considered for preterm infants.
  • Significant uncertainties exist regarding their efficacy and safety.
  • Mechanisms of action and optimal administration remain unclear.

Purpose of the Study:

  • To evaluate if current clinical evidence supports routine probiotic use in preterm infants.
  • To highlight knowledge gaps concerning probiotic benefits and risks.
  • To advocate for a cautious approach to introducing probiotics in neonatal practice.

Main Methods:

  • Review of clinical trial evidence on probiotic interventions in preterm neonates.
  • Analysis of uncertainties related to probiotic mechanisms, efficacy, and safety.
  • Consideration of ecological and long-term health consequences.

Main Results:

  • Current evidence is insufficient to justify routine probiotic use.
  • Significant gaps exist in understanding who benefits and potential harms.
  • Lack of defined probiotic products with established safety profiles.

Conclusions:

  • A precautionary principle should guide the introduction of probiotics.
  • Further research is needed to clarify efficacy, safety, and ecological impacts.
  • Monitoring of microbiological, ecological, and long-term outcomes is crucial before routine use.

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