Document Detail

Multi-modal approach to prophylaxis of necrotizing enterocolitis: clinical report and review of literature.
MedLine Citation:
PMID:  16775708     Owner:  NLM     Status:  MEDLINE    
For the first time a multimodal approach to NEC prophylaxis is reported, consisting of early trophic feeding with human breast milk, and enteral administration of an antibiotic, an antifungal agent, and probiotics. A retrospective analysis of local protocol of NEC prophylaxis is presented. Included were all VLBWI admitted to the NICU, including transfers within the first 28 days of life. These infants were divided into two groups, an "inborn group" (infants admitted within the first 24 h of life) and an "outborn group" (infants admitted after the onset of their second day of life). Prophylaxis of NEC according to protocol was started at the day of admission, and was continued until discharge. Between 1998 and 2004, 405 VLBWI were admitted, including all transfers within the first 28 days of life. A total of 334 (82%) infants were admitted within the first 24 h of life (inborn group), and 71 (18%) were admitted after 24 h of life (outborn group). Five infants developed clinical features of necrotizing enterocolitis. The inborn group showed a NEC incidence of 0.7% (two infants), whereas the outborn group showed a NEC incidence of 4.5% (three infants), respectively. This difference was significant (P=0.049, Fisher's exact test). A surgical treatment with bowel resection was performed in two infants (both from the outborn group). The present study used a combination of different strategies, all having shown to have some beneficial effect, but not having brought a clinical breakthrough in single administration studies. Combinated were the beneficial effects of human breast milk feeding, oral antiobiotics, oral antifungal agents, and the administration of probiotics. In a homogenous group of preterm infants, using this protocol of multimodal NEC prophylaxis, there was a very low incidence of NEC, when started within the first 24 h of life.
G Schmolzer; B Urlesberger; Michaela Haim; J Kutschera; G Pichler; E Ritschl; B Resch; F Reiterer; W Müller
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Publication Detail:
Type:  Journal Article; Review     Date:  2006-06-15
Journal Detail:
Title:  Pediatric surgery international     Volume:  22     ISSN:  0179-0358     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-06-29     Completed Date:  2007-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  573-80     Citation Subset:  IM    
Division of Neonatology, Department of Pediatrics, Medical University of Graz, Auenbruggerplatz 30, 8036, Graz, Austria.
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MeSH Terms
Breast Feeding
Combined Modality Therapy
Enterocolitis, Necrotizing / prevention & control*
Infant, Newborn
Infant, Very Low Birth Weight*
Retrospective Studies

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