Efficacy of saccharomyces boulardii on necrotizing enterocolitis or sepsis in very low birth weight infants: A randomised controlled trial

Background: Probiotics have strain specific effects and the effects of fungi in preventing diseases in preterm infants have been investigated poorly. Saccharomyces boulardii is a yeast which acts both as a probiotic and a polyamine producer. Aim: The objective of this study was to investigate the efficacy of S. boulardii in preventing necrotizing enterocolitis (NEC) or sepsis in very low birth weight infants. Study design and subjects: A prospective, double blind, placebo controlled trial was conducted in preterm infants (<= 32GWs, <= 1500 g birth weight). They were randomized either to receive feeding supplementation with S. boulardii 50 mg/kg every 12 h or placebo, starting with the first feed until discharged. Outcome measures: Necrotizing enterocolitis (NEC) or sepsis and NEC or death. Results: Birth weight and gestational age of the study (n = 104) and the control (n = 104) groups were 1126 +/- 232 vs 1162 +/- 216 g and 28.8 +/- 22 vs 28.7 +/- 2.1 weeks, respectively. Neither the incidence of stage >= 2 NEC or death nor stage >= 2 NEC or late onset culture proven sepsis was significantly lower in the study group when compared with the control group (9.6% vs 7.7%, p = 0.62; 28.8% vs 23%, p = 034). Time to reach 100 mL/kg/day of enteral feeding (11.9 +/- 7 vs 12.6 +/- 7 days, p = 037) was not different between the groups. Conclusions: Saccharomyces boulardii did not decrease the incidence of NEC or sepsis. (C) 2013 Elsevier Ireland Ltd. All rights reserved.