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Updated: Jul 18, 2026
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A Controlled Mouse Model for Neonatal Polymicrobial Sepsis
Published on: January 27, 2019
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Probiotic supplementation - does it prevent or cause neonatal sepsis?
Nicholas D Embleton1, Chris H P van den Akker2, Belal N Alshaikh3
1Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Newcastle University, Newcastle upon Tyne, UK.
Seminars in Fetal & Neonatal Medicine
|October 1, 2025
Summary
Probiotic supplementation significantly reduces necrotizing enterocolitis (NEC) and mortality in preterm infants. While effects on late-onset sepsis (LOS) are modest, the overall safety and benefits support their use in neonatology.
Area of Science:
- Neonatal Medicine
- Microbiome Research
- Clinical Nutrition
Background:
- Probiotic supplementation is widely studied in preterm infants.
- Over 50 randomized controlled trials exist for probiotics in neonatology.
- Established benefits include reduced necrotizing enterocolitis (NEC) and mortality.
Purpose of the Study:
- To examine the relationship between probiotic use and late-onset sepsis (LOS) in preterm infants.
- To review mechanistic pathways, clinical evidence, and safety data.
- To assess the overall benefit-risk profile of probiotics for preterm infants.
Main Methods:
- Systematic reviews and meta-analyses of randomized controlled trials.
- Analysis of mechanistic pathways for sepsis reduction.
- Evaluation of safety data, including adverse events and probiotic-induced sepsis.
- Assessment of evidence for NEC and mortality reduction.
Main Results:
- Probiotics show a modest effect on reducing LOS (RR 0.89, low certainty).
- Mechanisms include pathogen exclusion, enhanced barrier function, and improved immunity.
- Serious adverse events are rare; probiotic-induced sepsis is <0.5% risk.
- Robust evidence supports significant reduction in NEC and all-cause mortality.
Conclusions:
- Probiotics are highly beneficial for preterm infants, primarily for NEC and mortality reduction.
- The impact on LOS is currently considered modest with low certainty.
- The overall benefit-risk profile strongly favors probiotic use despite ongoing research needs for LOS and resistome impacts.
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