Impact of probiotics on a incidence of necrotizing enterocolitis in premature neonates in a level III NICU within a community hospital
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Publication Date
2025
Keywords
oregon, oaa 2025, psvmc
Disciplines
Critical Care | Medical Education | Pediatrics | Pharmacy and Pharmaceutical Sciences
Abstract
Abstract: Necrotizing enterocolitis (NEC) is a serious intestinal condition in neonates associated with significant morbidity and mortality. Evidence supporting the use of probiotics for prevention of NEC has prompted use among neonatal intensive care units (NICU) throughout the United States. In 2023, a case involving the death of a neonate with sepsis attributed to Bifidobacterium led to the FDA releasing multiple statements warning against the use of probiotics in neonates. The purpose of this study is to evaluate the efficacy and safety of probiotics in the prevention of NEC. This is a retrospective cohort study of patients admitted to the NICU from November 1, 2022 to August 31, 2023 and from November 1, 2023 to August 31, 2024. Data was collected utilizing chart review in an electronic medical record. The probiotic cohort is defined as patients admitted between November 1, 2022 and August 31, 2023, and the non-probiotic cohort is defined as patients admitted between November 1, 2023 and August 31, 2023. The primary outcome is the rate of NEC during hospital admission. Secondary outcomes include incidence of late onset sepsis, survival to discharge, and time to full enteral feeds. Investigators obtained institutional review board approval prior to data collection. After data collection, 63 patients were included in the probiotic cohort, and 64 patients were included in the non-probiotic cohort. Four patients developed NEC during admission; 1 from the probiotic group, and 3 from the non-probiotic group (p>0.30). Differences in rates of sepsis were not significant (p>0.80). Survival to discharge showed negligible difference between the two groups. Mann-Whitney test showed no difference for the endpoint to full enteral feeds (p>0.95). This study saw no difference in outcomes between probiotic and non-probiotic cohorts. Learning objective: Understand the hypothesized mechanism of action for probiotics in NEC. Discuss evidence for and against the use of probiotics to prevent NEC. Presentation Category: Pediatrics
Area of Special Interest
Women & Children
Specialty/Research Institute
Graduate Medical Education
Specialty/Research Institute
Perinatology/Neonatology
Specialty/Research Institute
Pharmacy
