Journal
CURRENT OPINION IN CLINICAL NUTRITION AND METABOLIC CARE
Volume 14, Issue 3, Pages 302-306Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCO.0b013e3283454e78
Keywords
necrotizing enterocolitis; preterm neonate; probiotics
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Purpose of review There is a lively discussion in literature whether routine use of probiotics should be recommended to reduce the incidence of severe necrotizing enterocolitis (NEC) and mortality in preterm infants. The aim of the present review is to analyze the level of evidence of published randomized controlled trials (RCTs) that different probiotic products reduce the incidence of severe NEC and mortality in preterm infants following Oxford Center for Evidence-based Medicine approach. Recent findings Application of probiotics is not a homogeneous intervention and meta-analyses across the available trials may be misleading with the risk that generalized conclusions are erroneously extrapolated to other probiotics. Each individual probiotic intervention should be analyzed separately. Currently, there are 16 RCTs studying 12 different probiotic preparations in preterm infants which report data on clinically important outcomes such as NEC, mortality, sepsis, or feeding advancement. Certain probiotics may be beneficial in relation to severe NEC (level of evidence, LoE 2b). Summary In circumstances of high local incidence of severe NEC, there is encouraging data (LoE 2b) for the use of probiotics. However, currently there is no level 1a evidence to recommend that all preterm infants should be fed probiotics routinely. Further, well designed RCTs on specific probiotics are required.
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