Multiple strains probiotics appear to be the most effective probiotics in the prevention of necrotizing enterocolitis and mortality: An updated meta-analysis

Hung Yang Chang, Jin Hua Chen, Jui Hsing Chang, Hung Chih Lin, Chien Yu Lin, Chun Chih Peng

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background: Some oral probiotics have been shown to prevent necrotizing enterocolitis (NEC) and decrease mortality effectively in preterm very low birth weight (PVLBW) infants. However, it is unclear whether a single probiotic or a mixture of probiotics is most effective for the prevention of NEC. Objective: A meta-analysis was conducted by reviewing the most up to date literature to investigate whether multiple strains probiotics are more effective than a single strain in reducing NEC and death in PVLBW infants. Data sources: Relevant studies were identified by searches of the MEDLINE, EMBASE, and Cochrane CENTRAL databases, from 2001 to 2016. Data extraction and synthesis: The inclusion criteria were randomized controlled trials of any enteral probiotic supplementation that was initiated within the first 7 days and continued for at least 14 days in preterm infants (≤ 34 weeks' gestation) and/or those of a birth weight ≤1500 g. Results: A total of 25 trials (n = 7345 infants) were eligible for inclusion in the meta-analysis using a fixed-effects model. Multiple strains probiotics were associated with a marked reduction in the incidence of NEC, with a pooled OR of 0.36 (95% CI, 0.24-0.53; P < .00001). Single strain probiotic using Lactobacillus species had a borderline effect in reducing NEC (OR of 0.60; 95% CI 0.36-1.0; P = .05), but not mortality. Multiple strains probiotics had a greater effectiveness in reducing mortality and were associated with a pooled OR of 0.58 (95% CI, 0.43-0.79; P = .0006). Trials using single strain of Bifidobacterium species and Saccharo-myces boulardii did not reveal any beneficial effects in terms of reducing NEC or mortality. Conclusion: This updated report found that multiple strains probiotics appear to be the most feasible and effective strategy for the prevention of NEC and reduction of mortality in PVLBW neonates. Further clinical trials should focus on which probiotic combinations are most effective.

Original languageEnglish
Article numbere0171579
JournalPLoS One
Volume12
Issue number2
DOIs
Publication statusPublished - Feb 1 2017

Fingerprint

enterocolitis
Necrotizing Enterocolitis
Probiotics
meta-analysis
probiotics
Meta-Analysis
Mortality
Very Low Birth Weight Infant
low birth weight
Bifidobacterium
Information Storage and Retrieval
Lactobacillus
Birth Weight
Premature Infants
MEDLINE
birth weight
Small Intestine
clinical trials
mouth
neonates

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Multiple strains probiotics appear to be the most effective probiotics in the prevention of necrotizing enterocolitis and mortality : An updated meta-analysis. / Chang, Hung Yang; Chen, Jin Hua; Chang, Jui Hsing; Lin, Hung Chih; Lin, Chien Yu; Peng, Chun Chih.

In: PLoS One, Vol. 12, No. 2, e0171579, 01.02.2017.

Research output: Contribution to journalArticle

@article{cc0e784ef2974d3aa51cc0b1407b5609,
title = "Multiple strains probiotics appear to be the most effective probiotics in the prevention of necrotizing enterocolitis and mortality: An updated meta-analysis",
abstract = "Background: Some oral probiotics have been shown to prevent necrotizing enterocolitis (NEC) and decrease mortality effectively in preterm very low birth weight (PVLBW) infants. However, it is unclear whether a single probiotic or a mixture of probiotics is most effective for the prevention of NEC. Objective: A meta-analysis was conducted by reviewing the most up to date literature to investigate whether multiple strains probiotics are more effective than a single strain in reducing NEC and death in PVLBW infants. Data sources: Relevant studies were identified by searches of the MEDLINE, EMBASE, and Cochrane CENTRAL databases, from 2001 to 2016. Data extraction and synthesis: The inclusion criteria were randomized controlled trials of any enteral probiotic supplementation that was initiated within the first 7 days and continued for at least 14 days in preterm infants (≤ 34 weeks' gestation) and/or those of a birth weight ≤1500 g. Results: A total of 25 trials (n = 7345 infants) were eligible for inclusion in the meta-analysis using a fixed-effects model. Multiple strains probiotics were associated with a marked reduction in the incidence of NEC, with a pooled OR of 0.36 (95{\%} CI, 0.24-0.53; P < .00001). Single strain probiotic using Lactobacillus species had a borderline effect in reducing NEC (OR of 0.60; 95{\%} CI 0.36-1.0; P = .05), but not mortality. Multiple strains probiotics had a greater effectiveness in reducing mortality and were associated with a pooled OR of 0.58 (95{\%} CI, 0.43-0.79; P = .0006). Trials using single strain of Bifidobacterium species and Saccharo-myces boulardii did not reveal any beneficial effects in terms of reducing NEC or mortality. Conclusion: This updated report found that multiple strains probiotics appear to be the most feasible and effective strategy for the prevention of NEC and reduction of mortality in PVLBW neonates. Further clinical trials should focus on which probiotic combinations are most effective.",
author = "Chang, {Hung Yang} and Chen, {Jin Hua} and Chang, {Jui Hsing} and Lin, {Hung Chih} and Lin, {Chien Yu} and Peng, {Chun Chih}",
year = "2017",
month = "2",
day = "1",
doi = "10.1371/journal.pone.0171579",
language = "English",
volume = "12",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "2",

}

TY - JOUR

T1 - Multiple strains probiotics appear to be the most effective probiotics in the prevention of necrotizing enterocolitis and mortality

T2 - An updated meta-analysis

AU - Chang, Hung Yang

AU - Chen, Jin Hua

AU - Chang, Jui Hsing

AU - Lin, Hung Chih

AU - Lin, Chien Yu

AU - Peng, Chun Chih

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background: Some oral probiotics have been shown to prevent necrotizing enterocolitis (NEC) and decrease mortality effectively in preterm very low birth weight (PVLBW) infants. However, it is unclear whether a single probiotic or a mixture of probiotics is most effective for the prevention of NEC. Objective: A meta-analysis was conducted by reviewing the most up to date literature to investigate whether multiple strains probiotics are more effective than a single strain in reducing NEC and death in PVLBW infants. Data sources: Relevant studies were identified by searches of the MEDLINE, EMBASE, and Cochrane CENTRAL databases, from 2001 to 2016. Data extraction and synthesis: The inclusion criteria were randomized controlled trials of any enteral probiotic supplementation that was initiated within the first 7 days and continued for at least 14 days in preterm infants (≤ 34 weeks' gestation) and/or those of a birth weight ≤1500 g. Results: A total of 25 trials (n = 7345 infants) were eligible for inclusion in the meta-analysis using a fixed-effects model. Multiple strains probiotics were associated with a marked reduction in the incidence of NEC, with a pooled OR of 0.36 (95% CI, 0.24-0.53; P < .00001). Single strain probiotic using Lactobacillus species had a borderline effect in reducing NEC (OR of 0.60; 95% CI 0.36-1.0; P = .05), but not mortality. Multiple strains probiotics had a greater effectiveness in reducing mortality and were associated with a pooled OR of 0.58 (95% CI, 0.43-0.79; P = .0006). Trials using single strain of Bifidobacterium species and Saccharo-myces boulardii did not reveal any beneficial effects in terms of reducing NEC or mortality. Conclusion: This updated report found that multiple strains probiotics appear to be the most feasible and effective strategy for the prevention of NEC and reduction of mortality in PVLBW neonates. Further clinical trials should focus on which probiotic combinations are most effective.

AB - Background: Some oral probiotics have been shown to prevent necrotizing enterocolitis (NEC) and decrease mortality effectively in preterm very low birth weight (PVLBW) infants. However, it is unclear whether a single probiotic or a mixture of probiotics is most effective for the prevention of NEC. Objective: A meta-analysis was conducted by reviewing the most up to date literature to investigate whether multiple strains probiotics are more effective than a single strain in reducing NEC and death in PVLBW infants. Data sources: Relevant studies were identified by searches of the MEDLINE, EMBASE, and Cochrane CENTRAL databases, from 2001 to 2016. Data extraction and synthesis: The inclusion criteria were randomized controlled trials of any enteral probiotic supplementation that was initiated within the first 7 days and continued for at least 14 days in preterm infants (≤ 34 weeks' gestation) and/or those of a birth weight ≤1500 g. Results: A total of 25 trials (n = 7345 infants) were eligible for inclusion in the meta-analysis using a fixed-effects model. Multiple strains probiotics were associated with a marked reduction in the incidence of NEC, with a pooled OR of 0.36 (95% CI, 0.24-0.53; P < .00001). Single strain probiotic using Lactobacillus species had a borderline effect in reducing NEC (OR of 0.60; 95% CI 0.36-1.0; P = .05), but not mortality. Multiple strains probiotics had a greater effectiveness in reducing mortality and were associated with a pooled OR of 0.58 (95% CI, 0.43-0.79; P = .0006). Trials using single strain of Bifidobacterium species and Saccharo-myces boulardii did not reveal any beneficial effects in terms of reducing NEC or mortality. Conclusion: This updated report found that multiple strains probiotics appear to be the most feasible and effective strategy for the prevention of NEC and reduction of mortality in PVLBW neonates. Further clinical trials should focus on which probiotic combinations are most effective.

UR - http://www.scopus.com/inward/record.url?scp=85012050869&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85012050869&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0171579

DO - 10.1371/journal.pone.0171579

M3 - Article

C2 - 28182644

AN - SCOPUS:85012050869

VL - 12

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 2

M1 - e0171579

ER -