Probiotics and the prevention of necrotizing enterocolitis
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In brief
In brief
Evidence-based review examining probiotic use for preventing necrotizing enterocolitis (NEC) in premature infants. Animal studies and clinical trials demonstrate that combination probiotics reduce NEC incidence, mortality, and sepsis risk in breast-fed preterm neonates by modulating intestinal microbiome and inflammation.
Written by the GCMD Library team from the article.
Background
Immaturity of the host immune system and alterations in the intestinal microbiome appear to be key factors in the pathogenesis of necrotizing enterocolitis (NEC). The aim of this paper is to weigh the evidence for the use of probiotics to prevent NEC in premature infants.
Methods
Animal studies, randomized controlled trials, observational cohort studies and meta-analyses involving administration of probiotic products for the prevention of NEC were reviewed. This review of the evidence summarizes the available preclinical and clinical data.
Results
In animal models probiotic microbes alter the intestinal microbiome, decrease inflammation and intestinal permeability and decrease the incidence and severity of experimental NEC. In randomized, placebo-controlled trials and cohort studies of premature infants, probiotic microbes decrease the risk of NEC, death and sepsis.
Conclusion
Evidence is strong for the prevention of NEC with the use of combination probiotics in premature infants who receive breast milk. The potential risks and benefits of probiotic administration to premature infants should be carefully reviewed with parents.
Type of study
Therapeutic.
Level of evidence
I.