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Short courses of dual‐strain probiotics appear to be effective in reducing necrotising enterocolitis
Author(s) -
Guthmann Florian,
Arlettaz Mieth Romaine P.,
Bucher Hans Ulrich,
Bührer Christoph
Publication year - 2016
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13280
Subject(s) - medicine , discontinuation , probiotic , necrotizing enterocolitis , gestational age , lactobacillus acidophilus , enterocolitis , antibiotics , confidence interval , bifidobacterium , neonatal intensive care unit , pediatrics , retrospective cohort study , pregnancy , lactobacillus , microbiology and biotechnology , food science , chemistry , genetics , bacteria , fermentation , biology
Aim Prophylactic probiotics to reduce necrotising enterocolitis ( NEC ) are mostly given for at least 28 days or until discharge. We describe the effects of a shorter duration dosing strategy. Methods Retrospective cohort study of neonates (birthweight 400–1500 g) in three neonatal intensive care units in Switzerland and Germany that embarked on probiotic prophylaxis given for 10 or 14 days, employing a fixed combination ( Lactobacillus acidophilus plus Bifidobacterium infantis , each 10 9 CFU/day) licensed as a drug in Switzerland. Probiotics were initiated upon discontinuation of antibiotics, or on day 1–3 in infants without antibiotics. Repeat probiotic courses were given whenever antibiotics had been instituted and were discontinued. Results Birthweight and gestational age were similar in the two 24‐month pre‐ and postimplementation cohorts. NEC rates fell from 33 of 633 (5.2%) to 8 of 591 infants alive at three days (1.4%; risk ratio ( RR ) 0.26, 95% confidence interval ( CI ) 0.12–0.55). The drop in NEC was significant both for infants of 400–999 g (6.4% to 2.5%) and 1000–1500 g birthweight (4.4% to 0.6%). Mortality was 5.1% (32/633) without, as opposed to 3.5% (21/591) with probiotics, respectively ( RR 0.69, 95% CI 0.41–1.19). Conclusion Short courses of a dual‐strain probiotics appear to be effective in reducing NEC .