Oral Probiotics Prevent Necrotizing Enterocolitis in Very Low Birth Weight Neonates

Bin‐Nun, Alona; Bromiker, Ruben; Wilschanski, Michael; Kaplan, Michael; Rudensky, Bernard; Caplan, Michael S.; Hammerman, Cathy

doi:10.1016/j.jpeds.2005.03.054

Cited by 496 publications

(367 citation statements)

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“…Several studies have shown a reduced incidence and severity of NEC in neonates treated with probiotics [12,[14][15][16][17][18][19][20]. Hoyos et al [18] noted an almost threefold reduction in the incidence of NEC after the administration of probiotics that included Lactobacillus acidophilus and Bifidobacterium infantis.…”

Section: Possible Treatment For Necmentioning

confidence: 99%

“…Hoyos et al [18] noted an almost threefold reduction in the incidence of NEC after the administration of probiotics that included Lactobacillus acidophilus and Bifidobacterium infantis. Infants treated with a probiotic mixture in two separate studies [19,20] showed a reduced incidence of NEC and decreased disease severity. Despite these trends, the appropriate timing and dosing of probiotic administration have not been determined.…”

Section: Possible Treatment For Necmentioning

confidence: 99%

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Using a mathematical model to analyze the role of probiotics and inflammation in necrotizing enterocolitis

Arciero

Ermentrout

Rubin

et al. 2009

Journal of Critical Care

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Background: Necrotizing enterocolitis (NEC) is a severe disease of the gastrointestinal tract of pre-term babies and is thought to be related to the physiological immaturity of the intestine and altered levels of normal flora in the gut. Understanding the factors that contribute to the pathology of NEC may lead to the development of treatment strategies aimed at re-establishing the integrity of the epithelial wall and preventing the propagation of inflammation in NEC. Several studies have shown a reduced incidence and severity of NEC in neonates treated with probiotics (beneficial bacteria species).

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Section: Possible Treatment For Necmentioning

confidence: 99%

Section: Possible Treatment For Necmentioning

confidence: 99%

Using a mathematical model to analyze the role of probiotics and inflammation in necrotizing enterocolitis

Arciero

Ermentrout

Rubin

et al. 2009

Journal of Critical Care

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“…Using Infloran (Laboratorio Farmaceutico), Lin et al (15) showed that 6/10 NEC cases in the control group, but only 0/2 in the study group, were Bell stage 3. Bin-Nun et al (18) also reported a significant reduction in NEC severity using ABCDophilus (Solgar). In our study, a detailed analysis of NEC cases including clinical and laboratory parameters did not reveal any changes in mortality, severe NEC (Bell's stage IIIb), or the clinical course of NEC.…”

Section: Discussionmentioning

confidence: 94%

Probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum) prevent NEC in VLBW infants fed breast milk but not formula

et al. 2014

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Background: Specific probiotics prevent necrotizing enterocolitis (NEC). A mixture of lactobacilli and bifidobacteria (Infloran) was highly effective in Asian very-low-birth-weight (VLBW) infants. We analyzed the effect of Infloran on NEC, NEC severity, and the influence of enteral feedings (breast milk vs. formula) on NEC prevention in a cohort of European VLBW infants. Methods: Infloran was implemented for routine use at our department. VLBW infants receiving probiotics were prospectively followed (2010)(2011)(2012) and compared with historic controls (2008)(2009). Data on NEC, neonatal morbidity, feeding tolerance, and descriptive parameters on NEC cases were analyzed. results: Infloran had no statistically significant impact on NEC (controls: 24/233 (10.3%); probiotics: 16/230 (7%); P = 0.2). However, NEC was significantly reduced in infants of the probiotics group who were fed any breast milk (20/179 (11.2%) vs. 10/183 (5.5%); P = 0.027), whereas it was ineffective in infants exclusively fed formula (4/54 (7.4%) vs. 6/44 (13.6%); P = 0.345). Occurrence of severe NEC (IIIb), time until full feeds, and gastric residuals were similar. conclusion: Infloran was of lower efficacy in a European VLBW cohort and showed a reduction of NEC only in infants fed breast milk. Future studies should investigate the influence of feeding formula or breast milk on the effect of probiotics.n ecrotizing enterocolitis (NEC) is an important cause of mortality and morbidity in premature infants (1). Although its pathogenesis is incompletely understood, a relation to an immature intestinal barrier, aberrant bacterial colonization, and enteral feedings is well established (2). Due to the seriousness of the disease, preventive strategies like the use of human milk and standardized feeding protocols (3-5) are of highest interest.Probiotics are microorganisms that confer a health benefit after ingestion (6). They are generally regarded as safe, and only single cases of sepsis were described in patients with major comorbidities (7). In preterm infants, probiotics may act beneficially by improving the intestinal barrier (8) and promoting a healthy gut microflora (9). Furthermore, they exert antiinflammatory effects on the gut epithelium (10) and improve local and systemic immune responses (11) that may strengthen a preterm infant's still immature immune defense. In the recent past, a preventive effect against NEC was assumed (12), and a variety of probiotic preparations were studied in randomized trials. Meta-analyses of these trials reported on a reduction of NEC in very-low-birth-weight (VLBW) infants by 65% (13,14), and the use of probiotics in clinical routine was recommended. Based on these suggestions, we decided to introduce probiotics for NEC prophylaxis as standard of care at our department. The probiotic preparation Infloran (Laboratorio Farmaceutico, Mede, Italia) consists of a mixture of Lactobacillus acidophilus and Bifidobacterium infantis and was chosen as its use was suggested by European experts (14) and it was available ...

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“…In 1999, Hoyos and colleagues reported the outcome of a cohort study, in which, probiotic administration was associated with a reduction in the incidence of necrotizing enterocolitis [53]. Between 2003 and 2006, several randomised studies reported a reduction in the incidence of NEC among preterm babies recruited to probiotic trials (and receiving the probiotic intervention) though not all these studies were designed to evaluate NEC as a primary outcome [54][55][56][57][58][59]. The first meta-analysis combining these results was published in 2007 and concluded that probiotics might reduce the risk of NEC in preterm babies born less 33 weeks gestation [60].…”

Section: Probiotics For the Prevention Of Necmentioning

confidence: 99%

“…The product implicated in this case is the same as that used in two previous randomised trials [56,66] (one of which was the large Australian ProPREMS study) though neither of these groups reported any serious events during the course of their trials. Adverse events associated with using bacteria to manipulate the flora of premature babies have previously been described.…”

Section: Safety Of Probiotics In Preterm Infantsmentioning

confidence: 99%

Probiotics and necrotizing enterocolitis

2015

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Oral Probiotics Prevent Necrotizing Enterocolitis in Very Low Birth Weight Neonates

Cited by 496 publications

References 23 publications

Using a mathematical model to analyze the role of probiotics and inflammation in necrotizing enterocolitis

Using a mathematical model to analyze the role of probiotics and inflammation in necrotizing enterocolitis

Probiotics (Lactobacillus acidophilus and Bifidobacterium bifidum) prevent NEC in VLBW infants fed breast milk but not formula

Probiotics and necrotizing enterocolitis

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