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Dose-interval study of a dual probiotic in preterm infants
Claire Watkins1,2,3, Kiera Murphy1, Eugene M Dempsey4,5
1Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland.
Insights
Daily Infloran probiotic administration is effective for preterm infants, significantly increasing Bifidobacterium levels up to 44 weeks postmenstrual age. This dosage supports gut health in the neonatal intensive care unit setting.
Area of Science:
- Neonatal Medicine
- Microbiology
- Gastroenterology
Background:
- Preterm infants (<32 weeks' gestation) have immature gut microbiota, increasing susceptibility to infections and complications.
- Probiotics, such as Infloran containing Bifidobacterium bifidum and Lactobacillus acidophilus, are explored to modulate gut microbiota in vulnerable neonates.
- Optimal dosing strategies for probiotic administration in preterm infants require further investigation.
Purpose of the Study:
- To determine the appropriate dosing interval for the probiotic Infloran in preterm infants.
- To compare the effects of daily, biweekly, and weekly Infloran administration on gut microbiota composition.
- To evaluate the safety and efficacy of different Infloran dosing regimens in preterm infants.
Main Methods:
- A randomized controlled trial involving preterm infants (<32 weeks' gestation) assigned to daily, biweekly, or weekly Infloran groups, plus a control group.
- Infloran (250 mg capsule containing 1x10^9 CFU Bifidobacterium bifidum and 1x10^9 CFU Lactobacillus acidophilus) administered at 2 mL/kg/day in breast milk.
- Stool samples collected at 31, 34, 41, and 44 weeks postmenstrual age (PMA) to analyze bacterial populations.
Main Results:
- Daily Infloran administration resulted in significantly higher Bifidobacterium levels at 31 weeks (45%) and 34 weeks (60% PMA) compared to biweekly, weekly, and control groups.
- A decrease in Streptococcaceae and Enterococcaceae was observed in all probiotic groups by 41 weeks PMA.
- Significantly higher Lactobacillus levels were found in the biweekly group (16.5%) compared to the weekly group (2.1%) at 44 weeks PMA.
Conclusions:
- Daily administration of Infloran is a suitable dosage for preterm infants in the neonatal intensive care unit.
- Daily dosing leads to significantly higher Bifidobacterium levels, indicating effective gut microbiota modulation.
- Further research may explore long-term effects and optimal probiotic strains for preterm infant gut health.
Objective:
The objective of this study was to investigate the appropriate dosing interval of a probiotic (Infloran) given daily, biweekly and weekly in preterm infants <32 weeks' gestation.
Methods:
There were 8 infants in the daily group, 8 infants in the biweekly group and 10 infants in the weekly group, all born between 25 and 32 weeks' gestation. The control group consisted of 12 preterm infants who did not receive the probiotic. Infloran (250 mg/capsule), containing Bifidobacterium bifidum (1×109 colony-forming unit (CFU)) and Lactobacillus acidophilus (1×109 CFU), was administered in 2.5 mL of breast milk per kilogram weight of the infant (2×109 CFU of bacteria in total), until 34 weeks postmenstrual age (PMA). Stool samples were collected at 31, 34, 41 and 44 weeks PMA and frozen at -20°C.
Results:
After administration of the probiotic at 31 weeks PMA, Bifidobacterium were significantly higher in the daily group (45%) in comparison with the biweekly (17%) and weekly (9%) groups. At 34 weeks PMA, Bifidobacterium were significantly higher again in the daily (60%) group in comparison with the biweekly (21%), weekly (23%) and control (15%) groups. At 41 weeks PMA a decrease in the relative abundances of Streptococcaceae and Enterococcaceae was found in all three probiotic groups, and by 44 weeks PMA significantly higher levels of Lactobacillus were found in the biweekly group (16.5%) in comparison with the weekly group (2.1%).
Conclusion:
Our results indicate that a daily dose of Infloran is a suitable dosage for preterm infants in the neonatal intensive care unit, with significantly higher levels of Bifidobacterium found in the daily probiotic group up to 44 weeks PMA.
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