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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT01788761
Other study ID # pROBIOTICS11
Secondary ID
Status Terminated
Phase N/A
First received
Last updated
Start date July 2012
Est. completion date July 11, 2018

Study information

Verified date April 2017
Source Mercy Health System
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a research study that will look at the effects of giving two nutritional supplements on extremely low birth infants (infants weighing less than 1000 grams or weighing less than approximately 2 lbs 3 1/2 ounces at birth). The nutritional supplements that will be studied are Culturelle for Kids/Culturelle Kids and Align. They are nutritional supplements that each contain a different probiotic. In this study the investigators will mainly be looking at the effect that these supplements may have on how well babies tolerate their feedings and how long they require supplemental intravenous fluids for nutritional support. The investigators will also, however, look at many other factors such as rate of growth, rates of infection, survival rate and the length of time the infant needs to be in the hospital. The investigators will also look at its effect on conditions/complications of prematurity such as bronchopulmonary dysplasia and chronic lung disease (chronic diseases of the lung associated with prematurity), necrotizing enterocolitis and intestinal perforations (serious diseases of the infant's intestines), retinopathy of prematurity (eye disease associated with prematurity), intracranial hemorrhage (bleeding into the brain) and patent ductus arteriosus (a blood vessel connecting two main blood vessels coming out of the heart that does not close spontaneously (by itself).


Description:

The purpose of this research study is to investigate the effect of the administration of the nutritional supplements, Culturelle for Kids/Kids Culturelle in combination with Align, containing the Probiotics Lactobacillus GG and Bifidobacterium Infantis, on feeding tolerance (as determined by the number of days infant is without enteral feedings due to feeding intolerance, number of days infant requires supplemental hyperalimentation/intravenous fluids for nutritional support and number of days to achieve full enteral feedings) in high risk extremely low birth weight infants.


Recruitment information / eligibility

Status Terminated
Enrollment 133
Est. completion date July 11, 2018
Est. primary completion date July 11, 2018
Accepts healthy volunteers No
Gender All
Age group N/A to 14 Days
Eligibility Inclusion Criteria:

- Birthweight between 500-999 grams

- Apgar score greater than or equal to 3 at 5 minutes

- Infant free from any known major congenital anomalies or chromosomal/genetic anomalies

- Infant without any known cyanotic or complex congenital heart disease

- Infant NPO or on trophic enteral feedings than have been started less than 24 hours previously

- Infant without prior history of necrotizing enterocolitis or gastrointestinal perforation

- Infant without previous exposure to probiotics

- Infant that will be ready to start trophic feedings within the first 14 days of life

- Infant less than or equal to 14 days of age

- Infant born to HIV negative mother

- Written informed consent obtained from mother

Exclusion Criteria:

- Infant born to HIV positive mother

- Infant with history of prior probiotic exposure

- Infant greater than 14 days of age

- Infant on enteral feedings for greater than 24 hours

- Infant with major congenital anomaly/chromosomal or genetic anomaly

- Infant with cyanotic/complex congenital heart disease

- Infant with previous gastrointestinal perforation/necrotizing enterocolitis

- 5 minute Apgar score < 3

Study Design


Related Conditions & MeSH terms


Intervention

Dietary Supplement:
Probiotic Supplemented Group

Control Group


Locations

Country Name City State
United States Rockford Memorial Hospital Rockford Illinois

Sponsors (2)

Lead Sponsor Collaborator
Mercy Health System Rockford Memorial Hospital Development Foundation

Country where clinical trial is conducted

United States, 

References & Publications (25)

Alfaleh K, Anabrees J, Bassler D. Probiotics reduce the risk of necrotizing enterocolitis in preterm infants: a meta-analysis. Neonatology. 2010;97(2):93-9. doi: 10.1159/000235684. Epub 2009 Aug 25. Review. — View Citation

Amerifit Inc. Culturelle Probiotics for Kids. Packaging information 2010

Anderson, T., Lord, A., Shotkoski, N. and O'Keefe, C. The use of probioitics for the prevention of necrotizing enterocolitis in the premature infant. Infant, Child and Adolescent Nutrition 2009; October: 246-249.

Baldassarre ME, Laforgia N, Fanelli M, Laneve A, Grosso R, Lifschitz C. Lactobacillus GG improves recovery in infants with blood in the stools and presumptive allergic colitis compared with extensively hydrolyzed formula alone. J Pediatr. 2010 Mar;156(3):397-401. doi: 10.1016/j.jpeds.2009.09.012. Epub 2009 Nov 2. — View Citation

Bin-Nun A, Bromiker R, Wilschanski M, Kaplan M, Rudensky B, Caplan M, Hammerman C. Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates. J Pediatr. 2005 Aug;147(2):192-6. — View Citation

Chou IC, Kuo HT, Chang JS, Wu SF, Chiu HY, Su BH, Lin HC. Lack of effects of oral probiotics on growth and neurodevelopmental outcomes in preterm very low birth weight infants. J Pediatr. 2010 Mar;156(3):393-6. doi: 10.1016/j.jpeds.2009.09.051. Epub 2009 Nov 14. — View Citation

Dani C, Biadaioli R, Bertini G, Martelli E, Rubaltelli FF. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol Neonate. 2002 Aug;82(2):103-8. — View Citation

Deshpande G, Rao S, Patole S, Bulsara M. Updated meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates. Pediatrics. 2010 May;125(5):921-30. doi: 10.1542/peds.2009-1301. Epub 2010 Apr 19. — View Citation

Guenther K, Straube E, Pfister W, Guenther A, Huebler A. Sever sepsis after probiotic treatment with Escherichia coli NISSLE 1917. Pediatr Infect Dis J. 2010 Feb;29(2):188-9. doi: 10.1097/INF.0b013e3181c36eb9. — View Citation

Hojsak I, Abdovic S, Szajewska H, Milosevic M, Krznaric Z, Kolacek S. Lactobacillus GG in the prevention of nosocomial gastrointestinal and respiratory tract infections. Pediatrics. 2010 May;125(5):e1171-7. doi: 10.1542/peds.2009-2568. Epub 2010 Apr 19. — View Citation

Indrio F, Riezzo G, Raimondi F, Bisceglia M, Cavallo L, Francavilla R. Effects of probiotic and prebiotic on gastrointestinal motility in newborns. J Physiol Pharmacol. 2009 Dec;60 Suppl 6:27-31. — View Citation

Kuitunen M, Kukkonen K, Savilahti E. Pro- and prebiotic supplementation induces a transient reduction in hemoglobin concentration in infants. J Pediatr Gastroenterol Nutr. 2009 Nov;49(5):626-30. doi: 10.1097/MPG.0b013e31819de849. — View Citation

Ladd N, Ngo T. The use of probiotics in the prevention of necrotizing enterocolitis in preterm infants. Proc (Bayl Univ Med Cent). 2009 Jul;22(3):287-91. — View Citation

Lin HC, Hsu CH, Chen HL, Chung MY, Hsu JF, Lien RI, Tsao LY, Chen CH, Su BH. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics. 2008 Oct;122(4):693-700. doi: 10.1542/peds.2007-3007. — View Citation

Lin HC, Su BH, Chen AC, Lin TW, Tsai CH, Yeh TF, Oh W. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics. 2005 Jan;115(1):1-4. — View Citation

Luoto R, Isolauri E, Lehtonen L. Safety of Lactobacillus GG probiotic in infants with very low birth weight: twelve years of experience. Clin Infect Dis. 2010 May 1;50(9):1327-8. doi: 10.1086/651694. — View Citation

Ohishi A, Takahashi S, Ito Y, Ohishi Y, Tsukamoto K, Nanba Y, Ito N, Kakiuchi S, Saitoh A, Morotomi M, Nakamura T. Bifidobacterium septicemia associated with postoperative probiotic therapy in a neonate with omphalocele. J Pediatr. 2010 Apr;156(4):679-81. doi: 10.1016/j.jpeds.2009.11.041. — View Citation

Rinne M, Kalliomaki M, Arvilommi H, Salminen S, Isolauri E. Effect of probiotics and breastfeeding on the bifidobacterium and lactobacillus/enterococcus microbiota and humoral immune responses. J Pediatr. 2005 Aug;147(2):186-91. — View Citation

Rougé C, Piloquet H, Butel MJ, Berger B, Rochat F, Ferraris L, Des Robert C, Legrand A, de la Cochetière MF, N'Guyen JM, Vodovar M, Voyer M, Darmaun D, Rozé JC. Oral supplementation with probiotics in very-low-birth-weight preterm infants: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2009 Jun;89(6):1828-35. doi: 10.3945/ajcn.2008.26919. Epub 2009 Apr 15. — View Citation

Salminen S, Collado MC, Isolauri E, Gueimonde M. Microbial-host interactions: selecting the right probiotics and prebiotics for infants. Nestle Nutr Workshop Ser Pediatr Program. 2009;64:201-13; discussion 213-7, 251-7. doi: 10.1159/000235792. Epub 2009 Aug 19. — View Citation

Samanta M, Sarkar M, Ghosh P, Ghosh Jk, Sinha Mk, Chatterjee S. Prophylactic probiotics for prevention of necrotizing enterocolitis in very low birth weight newborns. J Trop Pediatr. 2009 Apr;55(2):128-31. doi: 10.1093/tropej/fmn091. Epub 2008 Oct 8. — View Citation

Scalabrin DM, Johnston WH, Hoffman DR, P'Pool VL, Harris CL, Mitmesser SH. Growth and tolerance of healthy term infants receiving hydrolyzed infant formulas supplemented with Lactobacillus rhamnosus GG: randomized, double-blind, controlled trial. Clin Pediatr (Phila). 2009 Sep;48(7):734-44. doi: 10.1177/0009922809332682. Epub 2009 Mar 4. — View Citation

Schanler RJ. Probiotics and necrotising enterocolitis in premature infants. Arch Dis Child Fetal Neonatal Ed. 2006 Nov;91(6):F395-7. — View Citation

Soll RF. Probiotics: are we ready for routine use? Pediatrics. 2010 May;125(5):1071-2. doi: 10.1542/peds.2010-0643. Epub 2010 Apr 26. — View Citation

Tarnow-Mordi WO, Wilkinson D, Trivedi A, Brok J. Probiotics reduce all-cause mortality and necrotizing enterocolitis: it is time to change practice. Pediatrics. 2010 May;125(5):1068-70. doi: 10.1542/peds.2009-2151. Epub 2010 Apr 19. — View Citation

* Note: There are 25 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Feeding Tolerance Feeding Tolerance as determined by the number of days infant is without enteral feedings due to feeding intolerance, number of days infant requires supplemental hyperalimentation/intravenous fluids for nutritional support and number of days to achieve full enteral feedings Evaluated on a daily basis until hospital discharge/transfer/death up until one year of age
Secondary Necrotizing Enterocolitis (Bell's Stage 2 or greater) Infants entire inpatient record assessed at/after time of hospital discharge/transfer/death up until 1 year of age
Secondary Culture proven sepsis without Necrotizing Enterocolitis Infants entire inpatient record assessed at/after time of hospital discharge/transfer/death up until one year of age
Secondary Chronic Lung Disease Infants entire inpatient record assessed at/after time of hospital discharge/transfer/death up until one year of age
Secondary Periventricular Leukomalacia Infant's entire inpatient record assessed at/after time of hospital discharge/transfer/death up until one year of age
Secondary Mortality Infant's entire inpatient record assessed at/after time of hospital discharge/transfer/death up until one year of age
Secondary Intraventricular Hemorrhage Infants entire inpatient record assessed at/after time of hospital discharge/transfer/death up until one year of age
Secondary Daily weight gain in grams Measured daily until time of hospital discharge/transfer/death up until one year of age
Secondary Discharge weight measured and expressed by percentile of growth for age Assessed at the time of discharge/transfer/death up until one year of age
Secondary Length of Stay Measured at time of discharge/transfer/death up until one year of age