Update in Pathogenesis and Prospective in Treatment of Necrotizing Enterocolitis

Table 2

Potential benefits and demonstrated limits of probiotics.

Rational for the use of probiotics	Probiotics use in the clinical practice
Probiotics supplementation inhibits pathogenic colonization and produces anti-inflammatory effects	Neonatal Intensive Care Units with higher rates of NEC are more likely to observe a benefit with probiotic supplementation
Probiotics secrete lactic acid to lower local pH, which inhibits the growth of pathogenic bacteria	Multistrain probiotics may be more effective than single-strain products
Probiotics communicate directly with pathogenic bacteria modulating their gene expression in order to reduce binding proteins to host epithelial cells	Extremely low-birth-weight infants may not benefit to the extent observed in those with greater gestational age or body birth weight
Probiotics stimulate production of secretory immunoglobulins and positively influence immunity response	Although reports of probiotic-related sepsis are limited, caution should be used when considering probiotic supplementation in infants at greatest risk for an impaired mucosal barrier
	Policies regarding storage, preparation, distribution, administration, and documentation of probiotics to ensure patient safety should be adopted