Prophylactic probiotics to prevent death and nosocomial infection in preterm infants
| Autor: | Luis Alfonso Perez, Maria M. Archila, Martín Rondón, Gloria Ruiz, Oscar Ovalle, María Ximena Rojas, Maria E. Tamayo, Jorge E. Garcia-Harker, Juan Lozano, Mario A. Rojas, Jaime Bastidas, Catherine Rojas, Mauricio Arevalo, Viviana Rodríguez, Adriana Ballesteros |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Infant Premature Diseases Placebo Gastroenterology law.invention Probiotic Double-Blind Method law Internal medicine medicine Humans Prospective Studies Cross Infection biology business.industry Probiotics Infant Newborn medicine.disease biology.organism_classification Confidence interval Infant mortality Lactobacillus reuteri Pneumonia Relative risk Pediatrics Perinatology and Child Health Necrotizing enterocolitis Female business |
| Zdroj: | Pediatrics. 130(5) |
| ISSN: | 1098-4275 |
| Popis: | BACKGROUND AND OBJECTIVE: It has been suggested that probiotics may decrease infant mortality and nosocomial infections because of their ability to suppress colonization and translocation of bacterial pathogens in the gastrointestinal tract. We designed a large double-blinded placebo-controlled trial using Lactobacillus reuteri to test this hypothesis in preterm infants. METHODS: Eligible infants were randomly assigned during the first 48 hours of life to either daily probiotic administration or placebo. Infants in the intervention group were administered enterally 5 drops of a probiotic preparation containing 108 colony-forming units of L reuteri DSM 17938 until death or discharge from the NICU. RESULTS: A total of 750 infants ≤2000 g were enrolled. The frequency of the primary outcome, death, or nosocomial infection, was similar in the probiotic and placebo groups (relative risk 0.87; 95% confidence interval: 0.63–1.19; P = .376). There was a trend toward a lower rate of nosocomial pneumonia in the probiotic group (2.4% vs 5.0%; P = .06) and a nonsignificant 40% decrease in necrotizing enterocolitis (2.4% vs 4.0%; P = .23). Episodes of feeding intolerance and duration of hospitalization were lower in infants ≤ 1500 g (9.6% vs 16.8% [P = .04]; 32.5 days vs 37 days [P = .03]). CONCLUSIONS: Although L reuteri did not appear to decrease the rate of the composite outcome, the trends suggest a protective role consistent with what has been observed in the literature. Feeding intolerance and duration of hospitalization were decreased in premature infants ≤1500 g. |
| Databáze: | OpenAIRE |
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