Effect of a Multi-Strain Probiotic on the Incidence and Severity of Necrotizing Enterocolitis and Feeding Intolerances in Preterm Neonates

Nutrients
Q1
Aug 2022
Citations:31
Influential Citations:0
Interventional (Human) Studies
86
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Methods
Double-blind, placebo-controlled, randomized clinical trial at Tygerberg Hospital NICU; 200 preterm neonates (<37 weeks gestation) with birthweight 750–1500 g (100 per group); sexes included (probiotic: 47 male/53 female; placebo: 37 male/63 female); HIV-exposed: 22 vs 26; majority cesarean births; empiric antibiotics at birth; neonates followed from birth to 28 days or discharge.
Intervention
LabinicTM multi-strain probiotic: Lactobacillus acidophilus 0.67 billion CFU; Bifidobacterium bifidum 0.67 billion CFU; Bifidobacterium infantis 0.67 billion CFU per day (total ~2.0 billion CFU). Administered once daily for 28 days, via nasogastric tube or orally.
Results
NEC occurred in 0/100 neonates in the probiotic group vs 5/100 in placebo (p<0.001); Bell stages II/III occurred only in placebo (2 cases). Feeding intolerance developed in 14% with probiotic vs 35% with placebo (p<0.001; crude OR 0.19, adjusted OR 0.11). Time to full feeds shorter with probiotic (8.7 vs 9.7 days). Emesis and abdominal distension were reduced; days with NPO were fewer; total days of TPN not significantly different. Authors conclude LabinicTM is a safe and cost-effective approach to reducing NEC and feeding intolerance in preterm neonates <1500 g.
Limitations
High transfer-out rate reducing observation time; single-center; 28-day follow-up; no microbiome or cross-colonization assessments.

Abstract

Background: Necrotizing enterocolitis (NEC) is a multifactorial disease, causing inflammation of the bowel. The exact root of NEC is still unknown, but a low weight and gestational age at birth are known causes. Furthermore, antibiotic use and abnorm...