Probiotics and necrotizing enterocolitis

• Type of Material: Article
• Authors: Ravi Mangal Patel, Emory University; Mark A. Underwood, University of California Davis
• Language: English
• Date: 2018-02-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1053/j.sempedsurg.2017.11.008
• Title of Journal or Parent Work: Seminars in Pediatric Surgery
• ISSN: 1055-8586
• Volume: 27
• Issue: 1
• Start Page: 39
• End Page: 46
• Grant/Funding Information: Mark Underwood was supported by NIH award R01 HD059127.; Ravi Patel was supported by NIH awards KL2 TR000455, UL1 TR000454 & K23 HL128942.
• Keywords: Gut; Neonate; Science & Technology; PRETERM INFANTS; Meta-analysis; LACTOBACILLUS-REUTERI; Preterm; PROPHYLACTIC PROBIOTICS; MILK; LATE-ONSET SEPSIS; PREVENTION; BIRTH-WEIGHT INFANTS; Surgery; BIFIDOBACTERIUM-BREVE; PATHOGENESIS; Bacteria; Pediatrics; Life Sciences & Biomedicine; EMPIRICAL ANTIBIOTIC-TREATMENT; Microbiome
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

In this review, we summarize existing knowledge regarding the effects of probiotics on necrotizing enterocolitis (NEC). We review the role of the microbiome in NEC and pre-clinical data on mechanisms of probiotic action. Next, we summarize existing randomized controlled trials and observational studies of probiotics to prevent NEC. We also summarize findings from several recent meta-analyses and report a new cumulative meta-analysis of probiotic trials. Finally, we review data from cohorts routinely using commercially available probiotics. Our goal is to inform clinicians about the risks and benefits of probiotics, which may be helpful for those considering use in preterm infants to prevent NEC, death, or sepsis.