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J Pediatr. 2014 Aug;165(2):285-289.e1. doi: 10.1016/j.jpeds.2014.04.029. Epub 2014 May 29.

Prophylactic use of Lactobacillus acidophilus/Bifidobacterium infantis probiotics and outcome in very low birth weight infants.

Author information

1
Department of Pediatrics, University at Lübeck, Lübeck, Germany. Electronic address: christoph.haertel@uksh.de.
2
Department of Pediatrics, University at Lübeck, Lübeck, Germany.
3
Institute for Medical Microbiology and Hygiene of the University at Lübeck, Lübeck, Germany.
4
Department of Neonatology, University of Tübingen, Tübingen, Germany.
5
Children's Hospitals Hannover Auf der Bult, Hannover, Germany.
6
Department of Pediatrics at University of Münster, Münster, Germany.
7
Department of Pediatrics, University of Greifswald, Greifswald, Germany.
8
Children's Hospital (Städtisches Klinikum) Nürmberg, Nürnberg, Germany.
9
Department of Pediatrics, GFO Hospitals Bonn, St. Marien Hospital, Bonn, Germany.
10
Department of Neonatology, Children's Hospital Hamburg-Altona, Hamburg-Altona, Germany.
11
Department of Neonatology and Pediatric Intensive Care, Klinikum Aschaffenburg, Aschaffenburg, Germany.

Abstract

OBJECTIVE:

To evaluate outcome data in an observational cohort of very low birth weight infants of the German Neonatal Network stratified to prophylactic use of Lactobacillus acidophilus/Bifidobacterium infantis probiotics.

STUDY DESIGN:

Within the observational period (September 1, 2010, until December 31, 2012, n=5351 infants) study centers were categorized into 3 groups based on their choice of Lactobacillus acidophilus/Bifidobacterium infantis use: (1) no prophylactic use (12 centers); (2 a/b) change of strategy nonuser to user during observational period (13 centers); and (3) use before start of observation (21 centers). Primary outcome data of all eligible infants were determined according to center-specific strategy.

RESULTS:

The use of probiotics was associated with a reduced risk for necrotizing enterocolitis surgery (group 1 vs group 3: 4.2 vs 2.6%, P=.028; change of strategy: 6.2 vs 4.0%, P<.001), any abdominal surgery, and hospital mortality. Infants treated with probiotics had improved weight gain/day, and probiotics had no effect on the risk of blood-culture confirmed sepsis. In a multivariable logistic regression analysis, probiotics were protective for necrotizing enterocolitis surgery (OR 0.58, 95% CI 0.37-0.91; P=.017), any abdominal surgery (OR 0.7, 95% CI 0.51-0.95; P=.02), and the combined outcome abdominal surgery and/or death (OR 0.43; 95% CI 0.33-0.56; P<.001).

CONCLUSIONS:

Our observational data support the use of Lactobacillus acidophilus/Bifidobacterium infantis probiotics to reduce the risk for gastrointestinal morbidity but not sepsis in very low birth weight infants.

PMID:
24880888
DOI:
10.1016/j.jpeds.2014.04.029
[Indexed for MEDLINE]

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