Oral Probiotics Reduce Incidence of Necrotizing Enterocolitis and Sepsis in Neonates with Hypoxic Ischemic Encephalopathy

Objective. We evaluated the efficacy of probiotics in reducing the incidence of feeding intolerance, necrotizing enterocolitis (NEC) and sepsis in full-term, bottle fed hypoxic ischemic encephalopathy (HIE)infants and verifies the viability of probiotic bacteria Lactobacilli in the stool and fecal IgA when lyophilized Lactobacillus acidophilus(L. acidophilus) was fed to those infants. Patients and Methods. A prospective, double blind, randomized, controlled clinical trial was conducted on 60 full-term newborns suffering from HIE grade II or III. They were randomized into 2 groups; the infants in the probiotic group were fed with lyophilized L. acidophilus in dose of 6 x 10 CFU divided into 2 doses/day in addition to the traditional HIE therapy until discharged while infants in the control group were given the traditional HIE therapy alone. Lactobacilli count and fecal IgA were determined at both day 7 and the end of the study. Primary outcome include NEC and sepsis. Results. A total of 60 HIE neonates were enrolled: 30 in the probiotic group and 30 in the control group. The incidence of NEC and sepsis was significantly lower in the probiotics group (16.7% vs. 33.3%, P=0.034 and 26.7% vs 73.3%, P= 0.0008, respectively). The fecal IgA concentration was significantly increased from day 7 to the end of the study in the probiotic group (6.9±1), but not in the control group (2.8±1.2, P<0.0001).Conclusion. The supplementation of lyophilized Lactobacilli acidophilus in full-term newborns with HIE grades (II,III) was beneficial, as it enhances the tolerability to enteral feeding and decreases the incidence of feeding intolerance, NEC and sepsis in our neonates. [Mohamed S Elfrargy, Azza M. Hassan and Marwa Abd-El-Wahab. Oral Probiotics Reduce Incidence of Necrotizing Enterocolitis and Sepsis in Neonates with Hypoxic Ischemic Encephalopathy. J Am Sci 2014;10(10):6-10]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 2