Probiotics Reduce Necrotizing Enterocolitis Severity in HIV-exposed Premature Infants.
What this study found
Overall, probiotic supplementation reduced necrotizing enterocolitis in the cohort, and in HIV-exposed infants it was associated more with reduced severity than with clear prevention of severe disease. In the HIV-exposed probiotic arm, all stages of NEC occurred in 3 (3%) versus 6 (6%) in placebo (p=0.029), with Bell's I in 2 (5%) versus 0 (p=0.045) and Bell's III in 0 versus 2 (5%) (p=0.36). In HIV-unexposed infants, time to full feeding was shorter with probiotics: 9.63 ± 2.42 vs 11.14 ± 4.15 days (p=0.022).
- Study & population
- Single-center randomized placebo-controlled study in premature very low birth weight infants in a South African neonatal unit.
- Intervention
- Pro-B2 probiotic was given daily as five drops mixed with breast milk and administered orally or via orogastric tube.
- Key limitation
- Findings come from a single neonatal unit with small HIV-exposed and HIV-unexposed subgroup sample sizes, limiting precision and generalizability.
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Open PDFOriginal abstract
OBJECTIVE To assess the effect of probiotics on the incidence of necrotizing enterocolitis (NEC) in premature infants born to human immunodeficiency virus (HIV)-positive and HIV-negative women. PATIENTS AND METHODS HIV-exposed and HIV-unexposed premature infants were randomized to either the probiotic or the placebo group. The probiotic consisted of 1 × 10(9) colony-forming units, Lactobacillus rhamnosus GG and Bifidobacterium infantis per day. RESULTS In total, 74 HIV-exposed and 110 HIV-unexposed infants were enrolled and randomized. The incidence of death [4 (5.4%) vs. 7 (6%); p = 0.79] and NEC [4 (5%) vs. 5 (5%); p = 0.76] did not differ significantly between the HIV-exposed and HIV-unexposed groups. A significant difference was found for total NEC incidence between the study and control groups [3 (3%) vs. 6 (6%); p = 0.029]. The incidence of NEC in the HIV-exposed group differed significantly [Bells I 2 (5%) vs. Bells III 2 (5%); p = 0.045). CONCLUSION Probiotic supplementation reduced the incidence of NEC in the premature very low birth weight infants; however, results failed to show a lower incidence of NEC in HIV-exposed premature infants. A reduction in the severity of disease was found in the HIV-exposed study group.