How frequent is routine use of probiotics in UK neonatal units?

Patel, Neaha; Evans, Katie; Berrington, Janet; Szatkowski, Lisa; Costeloe, Kate; Ojha, Shalini; Fleming, Paul; Battersby, Cheryl; NeoTRIPS Collaborative Group

Abstract

Objective There is a lack of UK guidance regarding routine use of probiotics in preterm infants to prevent necrotising enterocolitis, late-onset sepsis and death. As practices can vary, we aimed to determine the current usage of probiotics within neonatal units in the UK.

Design and setting Using NeoTRIPS, a trainee-led neonatal research network, an online survey was disseminated to neonatal units of all service levels within England, Scotland, Northern Ireland and Wales in 2022. Trainees were requested to complete one survey per unit regarding routine probiotic administration.

Results 161 of 188 (86%) neonatal units responded to the survey. 70 of 161 (44%) respondents routinely give probiotics to preterm infants. 45 of 70 (64%) use the probiotic product Lactobacillus acidophilus NCFM/Bifidobacterium bifidum Bb-06/B. infantis Bi-26 (Labinic™). 57 of 70 (81%) start probiotics in infants ≤32 weeks’ gestation. 33 of 70 (47%) had microbiology departments that were aware of the use of probiotics and 64 of 70 (91%) had a guideline available. Commencing enteral feeds was a prerequisite to starting probiotics in 62 of 70 (89%) units. The majority would stop probiotics if enteral feeds were withheld (59 of 70; 84%) or if the infant was being treated for necrotising enterocolitis (69 of 70; 99%). 24 of 91 (26%) units that did not use probiotics at the time of the survey were planning to introduce them within the next 12 months.

Conclusions More than 40% of all UK neonatal units that responded are now routinely administering probiotics, with variability in the product used. With increased probiotic usage in recent years, there is a need to establish whether this translates to improved clinical outcomes.

Citation

Patel, N., Evans, K., Berrington, J., Szatkowski, L., Costeloe, K., Ojha, S., Fleming, P., Battersby, C., & NeoTRIPS Collaborative Group. (2023). How frequent is routine use of probiotics in UK neonatal units?. BMJ Paediatrics Open, 7(1), Article e002012. https://doi.org/10.1136/bmjpo-2023-002012

• Journal Article Type: Article
• Acceptance Date: May 27, 2023
• Online Publication Date: Jul 14, 2023
• Publication Date: 2023-07
• Deposit Date: Nov 4, 2023
• Publicly Available Date: Nov 6, 2023
• Journal: BMJ Paediatrics Open
• Electronic ISSN: 2399-9772
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 1
• Article Number: e002012
• DOI: https://doi.org/10.1136/bmjpo-2023-002012
• Keywords: Pediatrics, Perinatology and Child Health
• Public URL: https://nottingham-repository.worktribe.com/output/23220561
• Publisher URL: https://bmjpaedsopen.bmj.com/content/7/1/e002012