Necrotizing Enterocolitis

Abstract

In their informative review of necrotizing enterocolitis, Neu and Walker (Jan. 20 issue)¹ seem to be unduly selective in summarizing the evidence about probiotics,² by omitting two systematic reviews.^3,4 One review, in which methods that follow Cochrane guidelines were used to evaluate 11 randomized, controlled trials involving 2176 preterm infants, showed that probiotics reduced the rate of death from any cause by over one half (risk ratio, 0.42; 95% confidence interval [CI], 0.29 to 0.62; P3 A Cochrane review showed similar effects⁴ and recommended a change in practice for infants with a birth weight over 1000 g. Neu and Walker noted that there was an increased rate of sepsis in association with probiotics in one trial, but neither meta-analysis showed an increased rate of sepsis.^3,4