Probiotika

Zusammenfassung

Nosokomiale Infektionen, Infektionen durch antibiotikaresistente Keime, systemische Inflamationsreaktionen und auch die nekrotisierende Enterokolitis (NEK) treten bei Frühgeborenen häufiger als bei Reifgeborenen auf. Die bisherigen Studien stützen die Hypothese, dass Probiotika, die NEK-Inzidenz (Bell-Stadium ≥2) und die Mortalität reduzieren und eventuell auch den Nahrungsaufbau beschleunigen. Diese Ergebnisse sind vielversprechend, bedürfen aber der Bestätigung in großen Studien. Unklar ist, welches Probiotikum besonders gut geeignet ist, welche Dosis optimal ist, wann und wie am besten begonnen wird oder ob ein einzelner Keim oder eine Kombination gegeben werden soll. Die Sicherheit und die Effizienz eines jeden Präparates müssen separat gezeigt werden.

Zusammenfassend gibt es derzeit nicht genug Studiendaten, um Probiotika bei sehr kleinen Frühgeborenen in der klinischen Routine als sichere und effektive Therapie außerhalb von Studien einzusetzen. Auf der anderen Seite ist es medizinisch nicht falsch, Probiotika unter kontrollierten Bedingungen, z. B. bei vorübergehend hoher lokaler NEK-Inzidenz, einzusetzen. Die vorliegende Arbeit untersucht die Beweiskraft der bisherigen Untersuchungsergebnisse.

Summary

The short term outcome of immature preterm infants is characterized by high morbidity and mortality. Probiotics have been suggested to be beneficial. The present systematic review meta-analysis the current literature on the effect of probiotics on mortality, time to full feeds, necrotizing enterocolitis and sepsis in very low birth weight infants. Special focus is given to methodological aspects of the available controlled randomized trials (RCT).

Schlüsselwörter

Frühgeborene - Probiotika - nekrotisierende Enterokolitis - Sepsis - Sterblichkeit - Nahrungsaufbau

Keywords

Preterm infants - probiotics - necrotizing entero colitis - sepsis - mortality - nutrition

• Literatur

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