title: Effectiveness of probiotics in the prophylaxis of necrotizing enterocolitis in preterm neonates: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To elucidate the benefits of using probiotics in the prevention of necrotizing enterocolitis (NEC) and its complications in preterm newborns.
  
  
  METHODS
  This was a systematic review of randomized controlled trials, which included studies retrieved from three databases (MEDLINE, Embase, and LILACS), using a combination of the terms (necrotizing enterocolitis) AND (probiotics).
  
  
  RESULTS
  11 randomized trials were included, totaling 2,887 patients, 1,431 in the probiotic group and 1,456 in the control group. There was a reduction in the incidence of NEC (NNT=25), overall death (NNT=34), and neonatal sepsis (NNT=34) in the probiotic group compared to the control group. Patients that received probiotic supplementation had lower food reintroduction time (p<0.001) and hospitalization time (p<0.001) when compared to those not receiving probiotics. There was no difference in mortality caused by NEC.
  
  
  CONCLUSIONS
  In premature newborns, the use of probiotics is effective as a prophylaxis for NEC and its complications.
authors.affiliation: Associação Médica Brasileira and Conselho Federal de Medicina. Professor, Evidence-based Medicine, Faculdade de Ciências Médicas de Santos (UNILUS), Santos, SP, Brazil. wmbernardo@usp.br
authors.forename: Wanderley Marques
authors.initials: WM
authors.lastname: Bernardo
authors.forename: Felipe Toyama
authors.initials: FT
authors.lastname: Aires
authors.forename: Renata Mota
authors.initials: RM
authors.lastname: Carneiro
authors.forename: Fernando Pereira de
authors.initials: FP
authors.lastname: Sá
authors.forename: Vera Esteves Vagnozzi
authors.initials: VE
authors.lastname: Rullo
authors.forename: Dennis Alexander
authors.initials: DA
authors.lastname: Burns
mesh_terms: D004750:Enteral Nutrition / Q000706:statistics & numerical data; D020345:Enterocolitis, Necrotizing / Q000401:mortality / Q000517:prevention & control*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D018805:Sepsis / Q000453:epidemiology