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Bifidobacterium breve M‐16V as a Probiotic for Preterm Infants: A Strain‐Specific Systematic Review

  • 2017-12-19
  • Journal of Parenteral and Enteral Nutrition 42(4)
    • G. Athalye-Jape
    • Shripada C Rao
    • K. Simmer
    • S. Patole

Abstract

Introduction: Bifidobacterium breve M-16V has been used as a probiotic in preterm infants. Probiotic strain-specific data are essential to guide clinical practice.

Objective: To assess effects of B breve M-16V in preterm neonates.

Design: A systematic review of randomized controlled trials (RCTs) and non-RCTs of B breve M-16V in preterm infants was conducted. Multiple databases, proceedings of Pediatric Academy Society, and other relevant conferences were searched in September 2016 and on January 5, 2017.

Results: Five RCTs (n = 482) and 4 non-RCTs (n = 2496) were included. Of the 5 RCTs, 4 carried high/unclear risk of bias in many domains. Meta-analysis (fixed effects model) of RCTs showed no significant benefits on stage ≥2 necrotizing enterocolitis, late-onset sepsis, mortality, and postnatal age at full feeds. Meta-analysis of non-RCTs showed significant benefits on (1) late-onset sepsis-3 studies (n = 2452), odds ratio = 0.56 (95% CI, 0.45-0.71), P < .0001; (2) mortality-2 studies (n = 2319), odds ratio = 0.61 (95% CI, 0.44-0.84), P = .002; and (3) postnatal age at full feeds (days)-2 studies (n = 361), mean difference, -2.42 (95% CI, -2.55 to -2.3), P < .00001. There were no adverse effects from B breve M-16V. On Grading of Recommendations, Assessment, Development, and Evaluation analysis, the overall quality of evidence was deemed very low.

Conclusions: Current evidence is limited regarding the potential of B breve M-16V in preterm neonates. Adequately powered, preferably cluster RCTs are needed to confirm these findings.

Keywords: Bifidobacterium breve; meta-analysis; necrotizing enterocolitis; preterm infants; systematic review.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Bifidobacterium breve M-16VReduced Age at Full Postnatal FeedsBeneficial
Moderate
Bifidobacterium breve M-16VReduced Colitis-Related MortalityBeneficial
Moderate
Bifidobacterium breve M-16VReduced Incidence of Late-Onset SepsisBeneficial
Moderate

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