Probiotics and prevention of neonatal necrotizing enterocolitis.
OBJECTIVE
This review will summarize the clinical trials evaluating the role of prophylactic probiotic supplementation in preterm infants in order to reduce the incidence of necrotizing enterocolitis (NEC).


RESULTS
Evidence suggests that probiotic supplementation in preterm infants reduces the incidence of NEC. In fact, recent meta-analyses have called for the use of probiotics as preventive therapy in subsets of this population. However, although multiple studies have evaluated the use of probiotics for this indication in preterm infants, these trials have used different formulations of bacteria, at differing doses and using varied protocols for administration; thus many unanswered questions remain. In addition, theoretical safety issues and concerns regarding quality of product still need to be addressed.


CONCLUSIONS
As NEC remains a serious problem for preterm neonates, proven therapies for prevention and treatment of this dreaded disease are needed. While the evidence does support a future role for probiotics in the prevention of NEC, it is of utmost importance to first ensure that a safe and high-quality product meeting rigorous standards will be provided to these at-risk infants.
Department of Pediatrics, NorthShore University Health System/Pritzker School of Medicine, University of Chicago, Evanston, Illinois 60201, USA. bfrost@northshore.org
Brandy L
BL
Frost
Michael S
MS
Caplan
D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019936:Probiotics / Q000008:administration & dosage / Q000627:therapeutic use*