Probiotics for prevention of necrotizing enterocolitis: Where do we stand?

Area of Science:

• Neonatal Medicine
• Microbiology
• Clinical Research

Background:

• Probiotics are increasingly considered for preterm infants to prevent common morbidities.
• Necrotizing enterocolitis, sepsis, and mortality remain significant concerns in this vulnerable population.

Approach:

• This review synthesizes historical data and recent evidence from randomized trials and cohort studies.
• It analyzes professional society guidelines and real-world data from North American centers.

Key Points:

• Evidence supports probiotics' potential to reduce necrotizing enterocolitis, sepsis, and mortality in preterm infants.
• Guidance statements offer recommendations, but interpretation requires careful consideration of study quality and context.
• Routine use involves practical considerations and complexities observed across multiple clinical settings.

Conclusions:

• Probiotic use in preterm infants is evolving, with growing evidence supporting benefits.
• Balancing evidence, guidelines, and clinical experience is crucial for optimizing their application.
• Further research and standardized reporting are needed to fully elucidate the role of probiotics.