Answer: E (Both A and C)
A recent review of probiotics and necrotizing enterocolitis showed that pre-clinical, clinical, and observational data generally support the benefits of probiotics for decreasing necrotizing enterocolitis and all-cause mortality (but mixed results for the benefit on sepsis).
However, the author of the review recommends that clinicians consider a number of issues before using probiotics as routine use for this indication. Among the key recommendations is for clinicians and practices to use quality improvement principles to evaluate the benefits or harms of the commercially probiotics currently available for use, and to be aware of concerns over the potential risk of probiotic-related sepsis as has been reported in case studies.
In addition, the author highlights the limited data on long-term outcomes of probiotic use in preterm infant, and also the variability of optimal dose, age, and duration of treatment in the current clinical data.
Patel RM, Underwood MA. Probiotics and necrotizing enterocolitis. Seminars in Pediatric Surgery 2018;27:39-46.