Related Experiment Video
Updated: Jun 12, 2025
Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
Published on: July 28, 2022
Comparative efficacy of different single drugs to prevent necrotizing enterocolitis in preterm infants: an update
Jing Chen1, Xiao Chen2, Xiaoling Huang1
1Department of Neonatology, The First People's Hospital of Neijiang, Neijiang, China.
Insights
Arginine is the most effective drug for preventing necrotizing enterocolitis (NEC) in preterm infants, followed by probiotics. These interventions also help reduce NEC-associated sepsis and mortality.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Pharmacology
Background:
- Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease affecting preterm infants.
- Optimal preventative strategies for NEC are crucial for improving infant outcomes.
Purpose of the Study:
- To identify the most effective interventions for preventing NEC in preterm infants.
- To compare the efficacy of lactoferrin, probiotics, prebiotics, glutamine, arginine, and erythropoietin (EPO) in NEC prevention.
Main Methods:
- A systematic literature search was conducted across major databases for randomized controlled trials (RCTs) up to June 20, 2024.
- Network meta-analysis (NMA) was employed to compare the efficacy of various interventions.
- Surface under the cumulative ranking curve (SUCRA) was used to rank interventions.
Main Results:
- Arginine showed the highest efficacy in reducing NEC incidence, followed by probiotics.
- Lactoferrin was most effective in preventing NEC-associated sepsis.
- Prebiotics impacted overall mortality and hospital stay, while glutamine expedited full enteral feeding.
Conclusions:
- Arginine is recommended as a first-line intervention for NEC prevention in preterm infants due to its efficacy in reducing NEC, septicemia, and mortality.
- Probiotics are suggested as a second-line option for NEC prevention.
Objective:
To investigate an optimal regimen of six drugs, including lactoferrin, probiotics, prebiotics, glutamine, arginine and erythropoietin (EPO), for the prevention of necrotizing enterocolitis (NEC) in preterm infants.
Methods:
PubMed, Embase, Ovid, The Cochrane Library, and Web of Science databases were searched for randomized controlled trials (RCTs) investigating the efficacy of lactoferrin, probiotics, prebiotics, glutamine, arginine, and EPO in preventing NEC in preterm infants, with a cutoff date of June 20, 2024. Two authors independently screened studies and extracted all the data. Network meta-analysis (NMA) was conducted to compare the outcomes of different interventions, and group rankings were determined using the surface under the cumulative ranking curve (SUCRA).
Results:
A total of 89 RCTs with 26,861 preterm infants were included. Arginine demonstrated the highest clinical efficacy in reducing the incidence of NEC, with probiotics being the next most effective and the placebo being the least effective. Lactoferrin was identified as the most effective intervention for reducing the incidence of NEC-associated sepsis. Prebiotics showed the highest effect on overall mortality, reducing the beginning of enteral feeding, and were associated with the shortest hospital stay. Glutamine significantly decreased the time to full enteral feeding.
Conclusion:
Existing literature highlights arginine as the most efficacious pharmacological agent in preventing NEC in preterm infants. It has been shown to effectively lower the rates of NEC, septicemia, and mortality, warranting its recommendation as the first-line clinical intervention. Following this, probiotics are recommended as a second option.
Related Concept Videos
01:27Combined Effects of Drugs: Synergism
Such synergistic combinations...
01:20Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...