Probiotics and Stool Colonisation Rates in Premature Infants
Probiotics confer their beneficial effects by colonising the gut. A blinded, four-armed, randomised, placebo-controlled trial published in the American Journal of Perinatology compared the stool colonisation rates in premature infants receiving high dose of probiotics with standard dose.
Premature infants with gestation age of 27–33 weeks, who were less than 96 hours of life, tolerant to at least 15 ml/kg/day of milk feeds and who were available for follow-up were recruited. A total of 149 premature infants were randomised as follows: group A, 1010 probiotic cells once every 12 hours for 21 days; group B, 1010 probiotic cells once every 12 hours for 14 days followed by placebo from days 15–21; group C, 109 probiotic cells once every 12 hours for 21 days; and group D, placebo for 21 days. The stool samples of all the infants were tested for colonisation with Lactobacillus or Bifidobacterium or Saccharomyces genera before and after intervention.
Before intervention, none of the stool samples had Lactobacillus or Bifidobacterium or Saccharomyces species. Colonisation rates with Lactobacillus and Bifidobacterium were significantly higher in premature infants belonging to groups A, B and C compared to those in the placebo group. The colonisation rates between groups A, B and C were comparable. However, a trend toward more number of colony forming units per millilitre of stool with Lactobacillus and Bifidobacterium was observed in group A (compared to group B) and group B (compared to group C).
The stool colonisation rate with probiotic species was similar in infants receiving high-dose and standard dose regimes. Further larger trials are needed to prove that higher dose and longer course of probiotics lead to better quantitative colonisation and longer duration of colonisation.
News source - Dutta S, Ray P, Narang A. Comparison of stool colonization in premature infants by three dose regimes of a probiotic combination: a randomized controlled trial. Am J Perinatol. 2015;32(8):733-40.