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Vol. 89. Issue 1.
Pages 18-24 (January - February 2013)
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Vol. 89. Issue 1.
Pages 18-24 (January - February 2013)
DOI: 10.1016/j.jped.2013.02.004
Open Access
Effectiveness of Probiotics in the Prophylaxis of Necrotizing Enterocolitis in Preterm Neonates: A Systematic Review and Meta-analysis
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4498
Wanderley Marques Bernardoa,
Corresponding author
wmbernardo@usp.br

Corresponding author.
, Felipe Toyama Airesb, Renata Mota Carneirob, Fernando Pereira de Sác, Vera Esteves Vagnozzi Rullod, Dennis Alexander Burnse
a Cientific Coordinator, Projeto Diretrizes, Associação Médica Brasileira and Conselho Federal de Medicina. Professor, Evidence-based Medicine, Faculdade de Ciências Médicas de Santos (UNILUS), Santos, SP, Brazil
b Medical Student, UNILUS, Santos, SP, Brazil
c Specialist, Sociedade Brasileira de Pediatria. Professor, Clinical Pediatrics, UNILUS, Santos, SP, Brazil
d Post-doctorate, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. Professor, Clinical Pediatrics, UNILUS, Santos, SP, Brazil
e Director, Sociedade Brasileira de Pediatria. President, Sociedade de Pediatria do Distrito Federal, Brasília, DF, Brazil
Article information
Abstract
Objective

To elucidate the benefits of using probiotics in the prevention of necrotizing enterocolitis (NEC) and its complications in preterm newborns.

Method

This was a systematic review of randomized controlled trials, which included studies retrieved from three databases (MEDLINE, Embase, and LILACS), using a combination of the terms (necrotizing enterocolitis) AND (probiotics).

Results

11 randomized trials were included, totaling 2,887 patients, 1,431 in the probiotic group and 1,456 in the control group. There was a reduction in the incidence of NEC (NNT=25), overall death (NNT=34), and neonatal sepsis (NNT=34) in the probiotic group compared to the control group. Patients that received probiotic supplementation had lower food reintroduction time (p<0.001) and hospitalization time (p<0.001) when compared to those not receiving probiotics. There was no difference in mortality caused by NEC.

Conclusion

In premature newborns, the use of probiotics is effective as a prophylaxis for NEC and its complications.

Keywords:
Home oxygen therapy
Children
Oxygen
Resumo
Objetivo

Elucidar os benefícios do uso de probióticos na prevenção de enterocolite necrosante (ECN) e de suas complicações em recém-nascidos prematuros.

Método

Revisão sistemática de ensaios clínicos randomizados, que incluiu pesquisas efetuadas em três bases de dados (MEDLINE, EMBASE e LILACS), utilizando a combinação dos termos (necrotizing enterocolitis) AND (probiotics).

Resultados

Foram incluídos 11 ensaios clínicos randomizados, totalizando 2.887 pacien- tes, sendo 1.431 no grupo Probiótico e 1.456 no grupo Controle. Houve redução na incidência de ECN (NNT=25), de morte global (NNT=34) e sepse neonatal (NNT=34) no grupo Probiótico em relação ao grupo Controle. Pacientes alimentados com suple- mentação de probióticos tiveram tempo de reintrodução alimentar (p<0,001) e de hospitalização (p<0,001) menor quando comparados aos que não receberam. Não houve diferença na mortalidade causada por ECN.

Conclusão

Em recém-nascidos prematuros, o uso de probióticos é eficaz na profilaxia de ECN e de suas complicações.

Palavras-chave:
Enterocolite necrosante
Probióticos
Prematuros
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Please, cite this article as: Adde FV, Alvarez AE, Barbisan BN, Guimarães BR. Recommendations for long-term home oxygen therapy in children and adolescents. J Pediatr (Rio J). 2013;89:6–17.

Copyright © 2013. Sociedade Brasileira de Pediatria
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