Responses

PDF

Recent advances in the management of infants born <1000 g
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

PLEASE NOTE:

  • Responses are moderated before posting and publication is at the absolute discretion of BMJ, however they are not peer-reviewed
  • Once published, you will not have the right to remove or edit your response. Removal or editing of responses is at BMJ's absolute discretion
  • If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patient's written consent to publication and send them to the editorial office before submitting your response [Patient consent forms]
  • By submitting this response you are agreeing to our full [Response terms and requirements]

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Dual-strain probiotics reduce NEC, mortality and neonatal bloodstream infections among extremely low birth weight (ELBW) infants
    • Luisa Anna Denkel, Infection epidemiologist Institute of Hygiene and Environmental Medicine, Charité University Medical Center
    • Other Contributors:
      • Frank Schwab, Mathematician
      • Lars Garten, Neonatologist
      • Christine Geffers, Infection control specialist
      • Petra Gastmeier, Head of department (Institute of Hygiene and Environmental Medicine)
      • Piening Brar, Infection control specialist

    Berrington and Ward Platt recently summarized current advances in the management of preterm infants born < 1000 g, so called extremely low birth weight (ELBW) infants (1). In this thoroughly done review, the authors highlighted the findings of the 2014 Cochrane review showing probiotics to reduce all-cause mortality and NEC in preterm infants, but not in the subgroup of ELBW infants (2). They hypothesized the lacking protective effect in this extremely vulnerable population to be attributable to their general immaturity, the timing of probiotic exposure or the small sample size of only 575 ELBW infants analyzed. Another recent meta-analysis did not show a significant beneficial effect of probiotics on sepsis in 771 ELBW infants included (3). This demands further studies with adequate power on the use of probiotics in infants born < 1000 g. Almost at the same time, we published a multi-center time series analysis supporting the beneficial effects of dual-strain probiotics on NEC, overall-mortality and nosocomial bloodstream infections (BSI) in preterm infants (4). Beyond that, we performed a subgroup analyses with 4683 ELBW infants. Routine use of dual-strain probiotics significantly reduced the risk of NEC (HR 0.48, 95 % CI 0.36 – 0.64), overall mortality (HR 0.59, 95 % CI 0.41 – 0.84) and nosocomial BSI (HR 0.83, 95 % CI 0.74 – 0.94) in this cohort. Further, probiotics also protected ELBW infants from mortality following NEC (HR 0.40, 95 % CI 0.19 – 0.85). Up to dat...

    Show More
    Conflict of Interest:
    None declared.