BMJ Paediatrics Open (Dec 2023)

How frequent is routine use of probiotics in UK neonatal units?

  • ,
  • Justinas Teiserskas,
  • Rachel Hutchinson,
  • Lisa Szatkowski,
  • Claire Caldwell,
  • Katie Taylor,
  • Emilie Seager,
  • Catherine Longley,
  • Rebecca Smith,
  • Brandy Cox,
  • Cheryl Battersby,
  • Helen Lloyd,
  • Aneurin Young,
  • Deborah Davidson,
  • Jennifer Peterson,
  • Emma Williams,
  • Kirti Gupta,
  • Ahmed Mohamed,
  • Paul Fleming,
  • Tal Oryan,
  • Mia Kahvo,
  • Arameh Aghababaie,
  • Janet Berrington,
  • Michelle Fernandes,
  • Neaha Patel,
  • Jessica Farnan,
  • Allan Jenkinson,
  • Bushra Abdul-Malik,
  • Lucinda Winckworth,
  • Kate Costeloe,
  • Christopher Freeman,
  • Katie Evans,
  • Jasmine Taylor,
  • Mary-Rose Ballard,
  • Rhiannon Jones,
  • Rajkumar Dhandayuthapani,
  • Caroline Fraser,
  • James Stevens,
  • Nuala Calder,
  • Amy Grant,
  • Moataz Badawy,
  • Afza Sadiq,
  • Manohar Joishy,
  • Nathan Collicott,
  • Naseem Sharif,
  • Spandana Rupa Madabhushi,
  • G Natasha,
  • Joe McConville,
  • Rhianna Netherton,
  • Lizaveta Collins,
  • Naomi Lin,
  • Kouros Driscoll,
  • Jonathan Talbot,
  • Rosie Roots,
  • Alison Hopper,
  • Camilla James,
  • Shreesh Bhat,
  • Lauren Ferretti,
  • Niha Peshimam,
  • Benjamin Holter,
  • Sion Glaze,
  • Anna Waghorn,
  • Shweta Dixit,
  • Chibuko Ukeje,
  • Shana Irvine,
  • Fergus Harnden,
  • Christine Lim,
  • Neelakshi Ghosh,
  • Eileen Foster,
  • Swati Jha,
  • Joanna O’Sullivan,
  • Evangelia Myttaraki,
  • Shreya Agrawal,
  • Steve Abbey,
  • Abdulhakim Abdurrazaq,
  • Saud Ahmed,
  • Faith Akano,
  • Muhammad Rehan Akhtar,
  • Oghenetekevwe Patrick Akpofure,
  • Myriam Segovia Almiron,
  • Namita Anand,
  • Jessica Archibald,
  • Harriet Aughey,
  • Lynnlette Aung,
  • Thandi Aung,
  • Pramila Bade,
  • Naomi Bell,
  • Andrada Maria Bianu,
  • Catherine Black,
  • Gennie Booth,
  • Karla Buerano,
  • Chinnu Chandran,
  • Shavin Chellen,
  • Ruth Cousins,
  • Leanne Dearman,
  • Alshaimaa Eldeeb,
  • Teim Eyo,
  • Yasin Fatine,
  • Poppy Flanagan,
  • Abhrajit Giri,
  • Saqib Hasan,
  • Craig Haverstock,
  • Jayne Hillier,
  • Kate Hooper,
  • Zoe Howard,
  • Mais Ismail,
  • Matilda Iverson,
  • Sam Jay,
  • Katie Jenkins,
  • Carla Kantyka,
  • Caroline Kargbo,
  • Almutassem Kazkaz,
  • Shelley Knights,
  • Nikoletta Kottarakou,
  • Carianne Lewis,
  • Carys Mangan,
  • Diane McCarter,
  • Aodhan McGillian,
  • Tasneem Modan,
  • Maria Orford,
  • Salil Pradhan,
  • Patrycja Prusak,
  • Ayesha Rahim,
  • Daniel Ratnaraj,
  • Naveed Shahzad,
  • Adwa Shalabi,
  • Claire Strauss,
  • Jane Sundarsingh,
  • Sumit Thankur,
  • Toby Thenat,
  • Alice Unsworth,
  • Carl Van Heyningen,
  • Elena Raluka Vlad

DOI
https://doi.org/10.1136/bmjpo-2023-002012
Journal volume & issue
Vol. 7, no. 1

Abstract

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Objective There is a lack of UK guidance regarding routine use of probiotics in preterm infants to prevent necrotising enterocolitis, late-onset sepsis and death. As practices can vary, we aimed to determine the current usage of probiotics within neonatal units in the UK.Design and setting Using NeoTRIPS, a trainee-led neonatal research network, an online survey was disseminated to neonatal units of all service levels within England, Scotland, Northern Ireland and Wales in 2022. Trainees were requested to complete one survey per unit regarding routine probiotic administration.Results 161 of 188 (86%) neonatal units responded to the survey. 70 of 161 (44%) respondents routinely give probiotics to preterm infants. 45 of 70 (64%) use the probiotic product Lactobacillus acidophilus NCFM/Bifidobacterium bifidum Bb-06/B. infantis Bi-26 (Labinic™). 57 of 70 (81%) start probiotics in infants ≤32 weeks’ gestation. 33 of 70 (47%) had microbiology departments that were aware of the use of probiotics and 64 of 70 (91%) had a guideline available. Commencing enteral feeds was a prerequisite to starting probiotics in 62 of 70 (89%) units. The majority would stop probiotics if enteral feeds were withheld (59 of 70; 84%) or if the infant was being treated for necrotising enterocolitis (69 of 70; 99%). 24 of 91 (26%) units that did not use probiotics at the time of the survey were planning to introduce them within the next 12 months.Conclusions More than 40% of all UK neonatal units that responded are now routinely administering probiotics, with variability in the product used. With increased probiotic usage in recent years, there is a need to establish whether this translates to improved clinical outcomes.