Effectiveness of two probiotics in the prevention of necrotizing enterocolitis in a cohort of very-low-birth-weight premature newborns

Abstract

Some studies have reported a decreased incidence of enterocolitis necrotizing after supplementation with probiotics. However, few studies have considered the equivalence or otherwise of different strains in preventing enterocolitis necrotizing in newborns. A prospective observational study was conducted in a cohort of 291 VLBW newborns, designed to assess the prevalence of enterocolitis necrotizing after receiving supplementation with the probiotic Inforan® (Berna Biotech, Madrid, Spain) 250 mg capsules containing 109 colony forming units (CFU) Lactobacillus acidophilus (ATCC 4356) and 109 CFU Lactobacillus. bifidum (ATCC 15696) (European Medicines Agency, 2014); Bivos® (Ferring, Madrid, Spain) containing Lacticaseibacillus rhamnosus (LGG) (ATCC 53103) (109 CFU); or no probiotic. Statistical analysis was performed using multivariant regression with days of parenteral nutrition, NICU stay, oxygenotherapy and chorioamnionitis. 173 VLBW newborns received probiotic supplementation, 65 received Infloran® and 108 Bivos®. In 72 VLBW newborns no probiotic was administered. We observed a significant association between reduction of necrotizing enterocolitis ≥ grade 2 and probiotic use. For Infloran® OR 0.174 (CI 95% 0.032, 0.936), for Bivos® OR 0.196 (CI95% 0.053, 0.732). Although both probiotics are associated with a lower prevalence of necrotizing enterocolitis in VLBW newborns, the comparison between Infloran® or Bivos® does not show significant differences.