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Probiotics and necrotizing enterocolitis.

Paul Fleming1,2, Nigel J Hall3,4, Simon Eaton5

  • 1Homerton University Hospital, London, UK.

Pediatric Surgery International
|September 23, 2015
PubMed
Summary
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Probiotics may reduce necrotizing enterocolitis (NEC) in premature infants, but more research is needed. Current evidence is insufficient to recommend universal probiotic use due to trial heterogeneity and underrepresentation of high-risk infants.

Area of Science:

  • Neonatal research
  • Gastroenterology
  • Microbiome studies

Background:

  • Necrotizing enterocolitis (NEC) is a serious condition in premature infants.
  • Probiotics are being investigated as a preventive measure for NEC.
  • Existing meta-analyses suggest potential benefits but have limitations.

Purpose of the Study:

  • To evaluate the efficacy and safety of probiotics for NEC prevention in premature infants.
  • To address the controversy surrounding routine probiotic administration.
  • To explore the mechanisms of probiotic action in NEC prevention.

Main Methods:

  • Review of heterogeneous randomized controlled trials.
  • Analysis of data on probiotic use in premature infants, including those with low birth weight (<1000 g).
Keywords:
Intestinal microbiotaNecrotizing enterocolitisPremature infantsPreventionProbioticsRandomised controlled trials

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  • Examination of existing meta-analyses and their limitations.

    • Main Results:

    • Combined data suggest probiotics may decrease NEC incidence.
    • High-risk infants (<1000 g) are under-represented in trials.
    • Evidence for efficacy and safety of universal prophylactic administration is inadequate.
    • Mechanisms of probiotic action remain unclear, though experimental evidence is emerging.

    Conclusions:

    • Routine probiotic administration for NEC prevention in premature infants is controversial.
    • Further research is required to establish clear guidelines.
    • Understanding probiotic mechanisms may lead to novel prevention strategies.