Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates.
OBJECTIVE
To test the hypothesis that normalizing the intestinal flora by administration of prophylactic probiotics would provide a natural defense, thereby reducing both the incidence and severity of necrotizing enterocolitis (NEC) in preterm neonates.


METHODS
Neonates < or =1500 g birth weight were randomized to either receive a daily feeding supplementation with a probiotic mixture (Bifidobacteria infantis, Streptococcus thermophilus, and Bifidobacteria bifidus; Solgar, Israel) of 10(9) colony forming units (CFU)/day or to not receive feed supplements. NEC was graded according to Bell's criteria.


RESULTS
For 72 study and 73 control infants, respectively, birth weight (1152 +/- 262 g vs 1111 +/- 278 g), gestational age (30 +/- 3 weeks vs 29 +/- 4 weeks), and time to reach full feeds (14.6 +/- 8.7 days vs 17.5 +/- 13.6 days) were not different. The incidence of NEC was reduced in the study group (4% vs 16.4%; P=.03). NEC was less severe in the probiotic-supplemented infants (Bell's criteria 2.3 +/- 0.5 vs 1.3 +/- 0.5; P=.005). Three of 15 babies who developed NEC died, and all NEC-related deaths occurred in control infants.


CONCLUSIONS
Probiotic supplementation reduced both the incidence and severity of NEC in our premature neonatal population.
Bin-Nun
Alona
A
Department of Neonatology and Laboratories, Shaare Zedek Medical Center, the Faculty of Medicine of the Hebrew University, Jerusalem, Israel.
Bromiker
Ruben
R
Wilschanski
Michael
M
Kaplan
Michael
M
Rudensky
Bernard
B
Caplan
Michael
M
Hammerman
Cathy
C
D000284:Administration, Oral; D001034:Apgar Score; D001644:Bifidobacterium / Q000276:immunology; D020345:Enterocolitis, Necrotizing / Q000145:classification / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D019936:Probiotics / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D048249:Streptococcus thermophilus / Q000276:immunology