ABSTRACT

Necrotizing enterocolitis (NEC) is a gastrointestinal disease characterized by intestinal ischemia which is one of the major causes of mortality and morbidity in preterm neonates. Recently, probiotics have been used for management of NEC. Lactobacillus species, Bifidobacterium and Saccharomyces boulardii are the most commonly used preparations. We presented a premature infant with recurrent NEC who was treated with Saccharomyces boulardii successfully.

A premature infant with a gestational age of 27 weeks and body weight of 900 gr was diagnosed as sepsis and NEC on postnatal fifth day. Physical examination was normal except abdominal distention and there was no peristaltic activity heard by auscultation. In laboratory evaluation, white blood cell count was 30500/mm3, Hb: 16.3 g/dL, platelets: 144000/mm3. Hepatic and renal function tests were within normal limits. Appropriate intravenous (İV) antibiotics and IV hydration were given. On postnatal 10th day, the infant was allowed to be fed by nasogastric tube but this was followed by NEC. After every feeding attempt on postnatal 18, 29, 45 and 64th days, the patient developed NEC; in each episode, he was treated with antibiotics. Oral Saccharomyces boulardii was given to treat recurrent NEC.

The premature infant with recurrent NEC was managed successfully by Saccharomyces boulardii as probiotic, a preparation available in Turkey. We did not observe any complications therefore this probiotic might be considered as a safe alternative. However, further studies are needed to confirm the effectiveness of probiotics to treat NEC during neonatal period.