Background and Importance Necrotising Enterocolitis (NEC) is a life-threatening intestinal inflammatory disease that primarily affects preterm infants. Risk factors include prematurity, low birth weight, and altered intestinal microbiota. Gastrointestinal colonisation by probiotic strains can avoid the overgrowth of potential pathogens.

Aim and Objectives Evaluate the use of a probiotic combination aiming to reduce the incidence of NEC in a level IV neonatal unit.

Material and Methods In April 2022, oral administration of a combination of probiotic bacteria (Bifidobacterium infantis, Bifidobacterium lactis and Streptococcus termophilus, Proprems®) was started aiming at decreasing NEC incidence in our unit. This probiotic combination is recommended by the most recent European Guidelines.

Neonates of gestational age (GA) ≤ 32 weeks, and GA ≤ 34,8 weeks with birth weight ≤ 1500 g were selected to receive probiotic (1 oral sachet/day, started in the first 72h of life), because of their high risk. They received it until postmenstrual age (PMA) of 34 weeks and 35,8 weeks respectively.

We conducted a retrospective observational review of medical records from April 2022–March 2023, collecting: GA, weight, days of life at start, treatment duration and breaks, PMA at removal and NEC episodes.

Results 50 out of 55 patients met criteria to receive probiotic (27 boys/23 girls). Median GA was 29,4 weeks (range: 23–34,7), median birth weight was 1kg (0,5–1,85) and 2 days of life at start, with 37 patients starting probiotic with less than 72h of life. Median of treatment duration was 24 days (2–71). As for removal, it was correct in 35 patients (11 patients later than indicated).

Treatment was safe and well-tolerated in all patients. No episodes of sepsis by the probiotic strains were recorded during this period.

NEC incidence on target population was 11,6%, with seven cases in 2022, decreased compared to 16% in 2020. Between April-December of 2022 there were four episodes of NEC, two of which have received probiotic.

Conclusion and Relevance The main deviations in the use of the probiotic according to established criteria were both late initiation and removal.

The selected formulation was safe and well-tolerated.

In the study period, a reduction of NEC incidence was observed associated to different measures and among them, the use of probiotic.

References and/or Acknowledgements 1. https://pubmed.ncbi.nlm.nih.gov/32332478/

2. https://pubmed.ncbi.nlm.nih.gov/33058137/

Conflict of Interest No conflict of interest.