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Published on: January 27, 2019

Influence of probiotics on faecal antibiotic resistome in neonates: a systematic review

Chandra Rath1,2, Anurag Fursule3, Florence Wong4

  • 1Neonatology, Centenary Hospital for Women and Children, Canberra, ACT, Australia. chandra.rath@research.uwa.edu.au.

Pediatric Research
|July 31, 2026
PubMed

Insights

Probiotic supplementation may reduce antimicrobial resistance (AMR) gene colonization in neonates. This systematic review suggests probiotics could be a strategy to combat AMR in infants.

Area of Science:

  • Neonatal health
  • Microbiome research
  • Antimicrobial resistance

Background:

  • Antimicrobial resistance (AMR) is a significant global health challenge.
  • Probiotics offer a potential preventive strategy against AMR.

Purpose of the Study:

  • To systematically review studies on the effect of probiotics on the neonatal fecal resistome.
  • To assess the role of probiotics in reducing AMR colonization in neonates.

Main Methods:

  • Systematic review of 18 studies (8 RCTs, 10 observational) involving 3496 neonates.
  • Searched databases in October 2025 for studies on fecal antibiotic resistome in neonates with and without probiotic supplementation.
  • Assessed risk of bias and certainty of evidence.

Main Results:

  • Ten studies reported a significant reduction in fecal antibiotic resistome with probiotic use.
  • Studies using culture or PCR methods were less likely to show reduction compared to metagenomic analyses.
  • No consistent associations found between probiotic dose/strain or feeding type and resistome colonization.
  • Most studies had a low risk of bias, but evidence certainty was low to very low.

Conclusions:

  • Probiotic supplementation shows potential in reducing neonatal fecal AMR gene colonization.
  • Future research needs standardized RCTs with quantitative AMR gene assessment and clinical outcomes.
  • Microbiome modulation with probiotics may complement antibiotic stewardship in combating neonatal AMR.
Abstract

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