Efficacy of Probiotics Versus Placebo in the Prevention of Necrotizing Enterocolitis in Preterm Very Low Birth Weight Infants: A Double-Blind Randomized Controlled Trial.
OBJECTIVE
To evaluate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis (NEC) in preterm very low birth weight (VLBW) infants.


METHODS
Arandomized double blind controlled trial.


METHODS
The Paediatrics Department of Sylhet M.A.G. Osmani Medical College Hospital, Sylhet Bangladesh, from July 2012 to June 2015.


METHODS
Preterm (28 - 33 weeks gestation) VLBW (birth weight 1000 - 1499 g) neonates were enrolled. The study group was fed with probiotics once daily with breast milk from first feeding, and the control group with only breast milk without the addition of probiotics. Both the groups received other standard care. The primary outcome was the development of NEC (stage II and III), categorized by modified Bell's classification.


RESULTS
In 108 neonates, development of NEC was significantly lower in the study group than that of control group [1 (1.9%) vs. 6 (11.5%); p=0.044]. Age of achievement of full oral feeding was significantly earlier in the study group than that in the control group (14.88 ±3.15 and 18.80 ±4.32 days; p < 0.001). Duration of hospital stay was significantly short in the study group compared to the control group (15.82 ±2.94 days vs. 19.57 ±4.26 days; p < 0.001).


CONCLUSIONS
Probiotic supplementation reduces the frequency of necrotising enterocolitis in preterm neonates with very low birth weight. It is also associated with faster achievement of full oral feeding and short duration of hospital stay.
Department of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh.
Tanjina
T
Chowdhury
Department of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh.
Muhammad Manajjir
MM
Ali
Department of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh.
Muhammad Monir
MM
Hossain
Department of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh.
Jugindra
J
Singh
Department of Ophthalmology, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh.
Abu Noyeem Muhammad
AN
Yousuf
Department of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh.
Fatema
F
Yasmin
Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, UK.
Fazle Rabbi
FR
Chowdhury
D000284:Administration, Oral; D001459:Bangladesh / Q000453:epidemiology; D019587:Dietary Supplements; D004311:Double-Blind Method; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007779:Lactobacillus acidophilus; D007902:Length of Stay; D008297:Male; D008895:Milk, Human; D019936:Probiotics / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome