Microbiome-targeting therapies in the neonatal intensive care unit: safety and efficacy
- PMID: 37358104
- PMCID: PMC10294772
- DOI: 10.1080/19490976.2023.2221758
Microbiome-targeting therapies in the neonatal intensive care unit: safety and efficacy
Abstract
Microbiome-targeting therapies have received great attention as approaches to prevent disease in infants born preterm, but their safety and efficacy remain uncertain. Here we summarize the existing literature, focusing on recent meta-analyses and systematic reviews that evaluate the performance of probiotics, prebiotics, and/or synbiotics in clinical trials and studies, emphasizing interventions for which the primary or secondary outcomes were prevention of necrotizing enterocolitis, late-onset sepsis, feeding intolerance, and/or reduction in hospitalization length or all-cause mortality. Current evidence suggests that probiotics and prebiotics are largely safe but conclusions regarding their effectiveness in the neonatal intensive care unit have been mixed. To address this ambiguity, we evaluated publications that collectively support benefits of probiotics with moderate to high certainty evidence in a recent comprehensive network meta-analysis, highlighting limitations in these trials that make it difficult to support with confidence the routine, universal administration of probiotics to preterm infants.
Keywords: Preterm infants; bifidobacteria; feeding intolerance; lactobacilli; late-onset sepsis; necrotizing enterocolitis; prebiotics; probiotics; synbiotics.
Conflict of interest statement
No potential conflict of interest was reported by the author(s).
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References
-
- Gasparrini AJ, Wang B, Sun X, Kennedy EA, Hernandez-Leyva A, Ndao IM, Tarr PI, Warner BB, Dantas G. Persistent metagenomic signatures of early-life hospitalization and antibiotic treatment in the infant gut microbiota and resistome. Nature Microbiol. 2019;4:2285–2297. doi:10.1038/s41564-019-0550-2. - DOI - PMC - PubMed
-
- Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, Thorp JM, Caritis SN, Prasad M, Tita ATN, et al. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol. 2016;215(1):.e103.1–.e103.14. doi:10.1016/j.ajog.2016.01.004. - DOI - PMC - PubMed
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