Enteral lactoferrin for the treatment of sepsis and necrotizing enterocolitis in neonates

Mohan Pammi, Steven Abrams

Research output: Contribution to journalReview article

Abstract

Background Neonatal sepsis and necrotizing enterocolitis (NEC) cause significant neonatal mortality and morbidity despite appropriate antibiotic therapy. Enhancing host defense and modulating inflammation by using lactoferrin as an adjunct to antibiotics in the treatment of sepsis, NEC, or both, may improve clinical outcomes. Objectives The primary objective was to assess safety and efficacy of oral lactoferrin as an adjunct to antibiotics in the treatment of neonates with suspected or confirmed sepsis, NEC, or both. Search methods We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 9), MEDLINE via PubMed, PREMEDLINE, (1966 to 20 September 2018) Embase (1980 to 20 September 2018), and CINAHL (1982 to 20 September 2018). We also searched clinical trial databases, conference proceedings, the reference lists of retried articles and clinical trials, and the authors’ personal files. Selection criteria We included randomized or quasi-randomized controlled trials evaluating enteral lactoferrin (at any dose or duration), used as an adjunct to antibiotic therapy, compared with antibiotic therapy alone (with or without placebo) or other adjuncts to antibiotic therapy to treat neonates at any gestational age up to 44 weeks’ postmenstrual age with confirmed or suspected sepsis or necrotizing enterocolitis (Bell’s Stage II or III). Data collection and analysis We used the standardized methods of Cochrane Neonatal for conducting a systematic review and for assessing the methodological quality of studies (neonatal.cochrane.org/en/index.html). The titles and the abstracts of studies identified by the search strategy were independently assessed by the two review authors and full text versions were obtained for assessment if necessary. Forms were designed to record trial inclusion/exclusion and data extraction. We used the GRADE approach to assess the quality of evidence. Main results We did not identify any eligible trials evaluating lactoferrin for the treatment of neonatal sepsis or NEC.

Original languageEnglish (US)
Pages (from-to)1-16
Number of pages16
JournalCochrane Database of Systematic Reviews
Volume2019
Issue number5
DOIs
StatePublished - May 11 2019

Fingerprint

Necrotizing Enterocolitis
Lactoferrin
Small Intestine
Sepsis
Anti-Bacterial Agents
Therapeutics
Clinical Trials
Infant Mortality
PubMed
MEDLINE
Patient Selection
Gestational Age
Randomized Controlled Trials
Placebos
Databases
Inflammation
Morbidity
Safety

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Enteral lactoferrin for the treatment of sepsis and necrotizing enterocolitis in neonates. / Pammi, Mohan; Abrams, Steven.

In: Cochrane Database of Systematic Reviews, Vol. 2019, No. 5, 11.05.2019, p. 1-16.

Research output: Contribution to journalReview article

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abstract = "Background Neonatal sepsis and necrotizing enterocolitis (NEC) cause significant neonatal mortality and morbidity despite appropriate antibiotic therapy. Enhancing host defense and modulating inflammation by using lactoferrin as an adjunct to antibiotics in the treatment of sepsis, NEC, or both, may improve clinical outcomes. Objectives The primary objective was to assess safety and efficacy of oral lactoferrin as an adjunct to antibiotics in the treatment of neonates with suspected or confirmed sepsis, NEC, or both. Search methods We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 9), MEDLINE via PubMed, PREMEDLINE, (1966 to 20 September 2018) Embase (1980 to 20 September 2018), and CINAHL (1982 to 20 September 2018). We also searched clinical trial databases, conference proceedings, the reference lists of retried articles and clinical trials, and the authors’ personal files. Selection criteria We included randomized or quasi-randomized controlled trials evaluating enteral lactoferrin (at any dose or duration), used as an adjunct to antibiotic therapy, compared with antibiotic therapy alone (with or without placebo) or other adjuncts to antibiotic therapy to treat neonates at any gestational age up to 44 weeks’ postmenstrual age with confirmed or suspected sepsis or necrotizing enterocolitis (Bell’s Stage II or III). Data collection and analysis We used the standardized methods of Cochrane Neonatal for conducting a systematic review and for assessing the methodological quality of studies (neonatal.cochrane.org/en/index.html). The titles and the abstracts of studies identified by the search strategy were independently assessed by the two review authors and full text versions were obtained for assessment if necessary. Forms were designed to record trial inclusion/exclusion and data extraction. We used the GRADE approach to assess the quality of evidence. Main results We did not identify any eligible trials evaluating lactoferrin for the treatment of neonatal sepsis or NEC.",
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