Department of Infection, Barts and The London NHS Trust, 80 Newark St, Whitechapel, London, UK.
Arch Dis Child Fetal Neonatal Ed. 2012 Jan;97(1):F70-4. doi: 10.1136/adc.2009.178939. Epub 2010 Sep 24.
Does the clinical trials' evidence of benefit justify the routine use of probiotics in the preterm infant? There are many uncertainties surrounding the use of probiotics in the preterm, including the mechanism(s) of action of probiotics, knowledge of who benefits and who might not, whether it is placement of large numbers of bacteria into the small intestine or colonisation that determines efficacy, the forms of microbial adaptation(s) and ecological consequences. There is also a current lack of defined products with associated evidence of safety in the preterm infant. It is argued that one cannot assume safety because of a lack of evidence of harm and that one should take a precautionary approach to the introduction of probiotics into routine neonatal practice. One should also consider how best one might monitor microbiological and ecological consequences and longer-term health outcomes before the introduction of this novel intervention into routine practice.
在早产儿中常规使用益生菌的临床获益证据是否合理？在早产儿中使用益生菌存在许多不确定性，包括益生菌的作用机制、谁受益谁可能不受益、是将大量细菌置于小肠还是结肠来决定疗效、微生物适应形式和生态后果。目前也缺乏在早产儿中具有安全性相关证据的明确产品。有人认为，由于缺乏危害证据，不能假定安全性，在将益生菌引入常规新生儿实践时应采取预防措施。在将这种新的干预措施引入常规实践之前，还应考虑如何最好地监测微生物学和生态学后果以及长期健康结果。
