Current Status of Probiotics for Preterm Infants

Area of Science:

• Neonatal Medicine
• Microbiology
• Clinical Research

Background:

• Probiotics demonstrate efficacy in reducing critical conditions like necrotizing enterocolitis (NEC), late onset sepsis (LOS), and mortality in preterm infants.
• Despite growing evidence from systematic reviews and RCTs, adoption of probiotics in neonatal care faces hesitation due to concerns regarding safety, product quality, and strain specificity.

Purpose of the Study:

• To review the current evidence and status of probiotic use in preterm infants.
• To discuss the challenges, future directions, and research scope for optimizing probiotic interventions in neonates.

Main Methods:

• Systematic reviews of randomized controlled trials (RCTs) and non-RCTs.
• Analysis of experimental studies and clinical data on probiotic interventions.
• Review of existing literature on probiotic efficacy and safety in preterm populations.

Main Results:

• Probiotics are associated with reduced risks of all-cause mortality, NEC (≥stage II), LOS, and feeding intolerance in preterm infants.
• Concerns about probiotic sepsis have been largely unsubstantiated, yet resistance to their use persists in some neonatal units.
• Strain-specific effects necessitate further research into optimal probiotic strains or combinations.

Conclusions:

• High-quality probiotic product development with stringent quality control is essential for safe and effective use.
• Further head-to-head comparisons are needed to identify optimal probiotic strains and combinations for preterm infants.
• Ongoing monitoring for adverse events, including probiotic sepsis and antibiotic resistance, is crucial for advancing probiotic therapy.