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What is the power of evidence recommending routine probiotics for necrotizing enterocolitis prevention in preterm infants?
MedLine Citation:
PMID:  21502919     Owner:  NLM     Status:  In-Data-Review    
PURPOSE OF REVIEW: There is a lively discussion in literature whether routine use of probiotics should be recommended to reduce the incidence of severe necrotizing enterocolitis (NEC) and mortality in preterm infants. The aim of the present review is to analyze the level of evidence of published randomized controlled trials (RCTs) that different probiotic products reduce the incidence of severe NEC and mortality in preterm infants following Oxford Center for Evidence-based Medicine approach.
RECENT FINDINGS: Application of probiotics is not a homogeneous intervention and meta-analyses across the available trials may be misleading with the risk that generalized conclusions are erroneously extrapolated to other probiotics. Each individual probiotic intervention should be analyzed separately. Currently, there are 16 RCTs studying 12 different probiotic preparations in preterm infants which report data on clinically important outcomes such as NEC, mortality, sepsis, or feeding advancement. Certain probiotics may be beneficial in relation to severe NEC (level of evidence, LoE 2b).
SUMMARY: In circumstances of high local incidence of severe NEC, there is encouraging data (LoE 2b) for the use of probiotics. However, currently there is no level 1a evidence to recommend that all preterm infants should be fed probiotics routinely. Further, well designed RCTs on specific probiotics are required.
Walter A Mihatsch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in clinical nutrition and metabolic care     Volume:  14     ISSN:  1535-3885     ISO Abbreviation:  Curr Opin Clin Nutr Metab Care     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9804399     Medline TA:  Curr Opin Clin Nutr Metab Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  302-6     Citation Subset:  IM    
Department of Pediatrics, Diakonieklinikum, Schwäbisch Hall, Germany.
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