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Utilization of a High Potency Probiotic Product for Prevention of Necrotizing Enterocolitis in Preterm Infants at a
Annie Bui1, Emory Johnson1, Michael Epshteyn1
1Department of Pharmacy (AB, EJ, ME), Medical City Dallas Hospital, Dallas, TX.
Insights
Probiotics can help prevent necrotizing enterocolitis (NEC), a serious infant condition. A neonatal intensive care unit saw reduced NEC cases after implementing a probiotic protocol, with no sepsis complications.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Preventive Medicine
Background:
- Necrotizing enterocolitis (NEC) is a significant cause of premature infant morbidity and mortality.
- No FDA-approved medications currently exist for NEC prevention.
- Meta-analyses suggest multi-strain probiotics may reduce NEC and mortality.
Purpose of the Study:
- To evaluate the impact of a probiotic protocol on NEC prevention in a Level IV NICU.
- To assess the safety and efficacy of probiotics in a high-risk premature infant population.
Main Methods:
- Implementation of a multi-strain probiotic protocol in a Level IV NICU in 2020.
- Observational analysis of NEC incidence before and after protocol implementation.
- Monitoring for probiotic-related sepsis events.
Main Results:
- A reduction in the incidence of necrotizing enterocolitis was observed following the probiotic protocol implementation.
- No cases of sepsis directly attributed to probiotic administration were reported.
- The protocol demonstrated potential for NEC prevention in premature infants.
Conclusions:
- A probiotic protocol can be an effective strategy for reducing NEC in premature infants.
- Probiotic use in the NICU setting appears safe, with no observed increase in sepsis.
- Further research is warranted to confirm these findings across diverse populations.
Abstract:
Necrotizing enterocolitis (NEC) is a serious gastrointestinal disease that can be seen in premature infants with high risk for morbidity and mortality. There is currently no US Food and Drug Administration (FDA) medication approved for the prevention of NEC. Despite great heterogeneity among available studies, large meta-analyses of clinical trials have demonstrated the efficacy of multiple-strain probiotics in reducing NEC and all-cause mortality. In 2020, Medical City Dallas's Level IV neonatal intensive care unit (NICU) implemented a probiotic protocol for NEC prevention. As a result, a reduction in NEC was observed, with no occurrence of probiotic-related sepsis.
