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Current Status of Probiotics for Preterm Infants

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Abstract

Probiotics have been shown to reduce the risk of all-cause mortality, necrotizing enterocolitis (NEC ≥ stage II), late onset sepsis (LOS), and feeding intolerance in preterm infants. Considering the substantial health burden imposed by these conditions, the importance of probiotics in preterm infants cannot be overemphasized. Based on the data from experimental studies, and systematic reviews of randomized controlled trials (RCTs) and non-RCTs, the uptake of this intervention in neonatal medicine has been increasing over the last few years. However, many are still hesitating to adopt this intervention for various reasons, including concerns about probiotic sepsis, product quality, and lack of clarity on optimal strain/s or their combinations. Some question the validity of meta-analyses of studies involving different probiotic strains or their combinations because probiotics effects are considered to be strain-specific. Some of the early concerns about probiotics in preterm infants have been shown to be unjustified. However, the resistance to probiotics continues in many neonatal units around the world. The future of probiotics for preterm infants depends on continued efforts to develop high-quality probiotic products using stringent quality control, improving access to such products, and robust head-to-head comparisons to know the optimal strains or their combinations. Monitoring for adverse effects such as probiotic sepsis and development of antibiotic resistance is crucial. The authors review the current status of probiotics in preterm infants and discuss the scope for further research in this field.

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Authors and Affiliations

  1. Department of Neonatology, Fiona Stanley Hospital, Perth, Western Australia

    Mangesh Deshmukh

  2. Department of Neonatology, St. John of God Subiaco Hospital, Perth, Western Australia

    Mangesh Deshmukh

  3. Neonatal Directorate, King Edward Memorial Hospital for Women, 374 Bagot Road, Subiaco, Western Australia, 6008

    Sanjay Patole

  4. School of Medicine, University of Western Australia, Perth, Western Australia

    Sanjay Patole

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  1. Mangesh Deshmukh
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  2. Sanjay Patole
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Both the authors contributed equally for all the sections of manuscript. SP will act as guarantor for the paper.

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Correspondence to Sanjay Patole.

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Deshmukh, M., Patole, S. Current Status of Probiotics for Preterm Infants. Indian J Pediatr 88, 703–708 (2021). https://doi.org/10.1007/s12098-021-03736-2

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