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BMC Medicine
Published in: BMC Medicine 1/2011

Open Access 01-12-2011 | Correspondence

Evidence-based guidelines for use of probiotics in preterm neonates

Authors: Girish C Deshpande, Shripada C Rao, Anthony D Keil, Sanjay K Patole

Published in: BMC Medicine | Issue 1/2011

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Abstract

Background

Current evidence indicates that probiotic supplementation significantly reduces all-cause mortality and definite necrotising enterocolitis without significant adverse effects in preterm neonates. As the debate about the pros and cons of routine probiotic supplementation continues, many institutions are satisfied with the current evidence and wish to use probiotics routinely. Because of the lack of detail on many practical aspects of probiotic supplementation, clinician-friendly guidelines are urgently needed to optimise use of probiotics in preterm neonates.

Aim

To develop evidence-based guidelines for probiotic supplementation in preterm neonates.

Methods

To develop core guidelines on use of probiotics, including strain selection, dose and duration of supplementation, we primarily used the data from our recent updated systematic review of randomised controlled trials. For equally important issues including strain identification, monitoring for adverse effects, product format, storage and transport, and regulatory hurdles, a comprehensive literature search, covering the period 1966-2010 without restriction on the study design, was conducted, using the databases PubMed and EMBASE, and the proceedings of scientific conferences; these data were used in our updated systematic review.

Results

In this review, we present guidelines, including level of evidence, for the practical aspects (for example, strain selection, dose, duration, clinical and laboratory surveillance) of probiotic supplementation, and for dealing with non-clinical but important issues (for example, regulatory requirements, product format). Evidence was inadequate in some areas, and these should be a target for further research.

Conclusion

We hope that these evidence-based guidelines will help to optimise the use of probiotics in preterm neonates. Continued research is essential to provide answers to the current gaps in knowledge about probiotics.
Appendix
Available only for authorised users
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Metadata
Title
Evidence-based guidelines for use of probiotics in preterm neonates
Authors
Girish C Deshpande
Shripada C Rao
Anthony D Keil
Sanjay K Patole
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2011
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-9-92

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