Safety and efficacy of probiotic administration to preterm infants: ten common questions

• Type of Material: Article
• Authors: Mark A Underwood, University of California Davis; Erin Arch M Umberger, Necrotizing Enterocolitis (NEC) Society; Ravi Patel, Emory University
• Language: English
• Date: 2020-08-28
• Publisher: SPRINGERNATURE
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020, International Pediatric Research Foundation, Inc
• Final Published Version (URL): http://dx.doi.org/10.1038/s41390-020-1080-6
• Title of Journal or Parent Work: PEDIATRIC RESEARCH
• Volume: 88
• Issue: Suppl 1
• Start Page: 48
• End Page: 55
• Grant/Funding Information: Publication of this article was sponsored by the Necrotizing Enterocolitis (NEC) Society, Patient-Centered Outcomes Research Institute, and National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development.; MAU received funding from the NIH: R01 HD059127 and R21 HD096247;RMP received funding from the NIH: KL2 TR000455, UL1 TR000454, and K23 HL128942. The NIH had no role in: (1) study design; (2) the collection, analysis, and interpretation of data; (3) the writing of the report; and (4) the decision to submit the paper for publication.
• Keywords: BIFIDOBACTERIUM-BREVE BBG-001; CANDIDA COLONIZATION; BIRTH-WEIGHT INFANTS; Science & Technology; INTESTINAL DYSBIOSIS; PREMATURE-INFANTS; Life Sciences & Biomedicine; Pediatrics; PROPHYLACTIC PROBIOTICS; MILK OLIGOSACCHARIDES; LACTOBACILLUS-RHAMNOSUS GG; NECROTIZING ENTEROCOLITIS; LATE-ONSET SEPSIS

Abstract

In spite of a large number of randomized placebo-controlled clinical trials and observational cohort studies including >50,000 preterm infants from 29 countries that have demonstrated a decrease in the risk of necrotizing enterocolitis, death, and sepsis, routine prophylactic probiotic administration to preterm infants remains uncommon in much of the world. This manuscript reflects talks given at NEC Society Symposium in 2019 and is not intended to be a state-of-the-art review or systematic review, but a summary of the probiotic-specific aspects of the symposium with limited additions including a recent strain-specific network analysis and position statement from the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). We address ten common questions related to the intestinal microbiome and probiotic administration to the preterm infant.