The Effects of Lactobacillus Reuteri DSM 17938 on Immunomodulation and Gastric Motility in Preterm Newborns

NCT ID: NCT00985816

Last Updated: 2011-11-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

EARLY_PHASE1

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-10-31

Study Completion Date

2011-10-31

Brief Summary

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The investigators propose a Phase II interventional trial to investigate the role of Lactobacillus reuteri DSM 17938 on the intestinal motility and immune response of premature infants and further evaluate safety of the use of this probiotic in a population of premature infants.

Detailed Description

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Hypothesis Administration of Lactobacillus reuteri to premature infants will improve their intestinal motility when compared with infants receiving placebo. Primary Objective Evaluate the effects of L. reuteri in the intestinal motility by measuring the gastric emptying rate in infants before and after 21 consecutive days of administration of L. reuteri.

Secondary Objectives 1. Mechanisms of action of L. reuteri - L.reuteri impact in the host immune response by determining fecal cytokines, sIgA and calprotectin before and after 21 days of administration - L.reuteri rate of colonization after its administration.

2\. Efficacy and safety of L. reuteri to premature infants - Clinical beneficial effects secondary to the administration of L. reuteri to premature infants. The following clinical outcomes will be identified and compared between groups:

* Number of gastrointestinal symptoms (regurgitation, vomiting, stasis)
* Days to full feeds. Number of days to reach full feeds defined as \> 120cc/kg/day) x2 days or more.
* Days on parenteral nutrition
* Weight gain defined as the number of days needed to reach 150% of birth weight
* Length of hospital stay
* Any possible side effects and adverse events secondary to the administration of L. reuteri to premature infants.
* Incidence of late onset sepsis.
* Incidence and severity of necrotizing enterocolitis categorized by Bell's classification
* Use of antibiotics (number of days on antibiotics during the hospital stay)
* Mortality (at 28 days after birth and at hospital discharge).

Conditions

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Preterm Birth

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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L reuteri DSM 17938

L. reuteri DSM 17938 will be given at a dose of 1x108 colony forming units (CFU)/day in an oil formulation delivered from a drop bottle. In the active study product, freeze-dried L. reuteri is suspended in a mixture of pharmaceutical grade medium chain triglycerides and sunflower oil together with pharmaceutical grade silicon dioxide to give the product the correct rheological properties (Connolly, 2005). The placebo consists of an identical formulation except that the L. reuteri is not present. This dose of the oil formulation with L. reuteri has been shown to induce significant colonisation in infants and is well-tolerated (Abrahamsson et al., 2007; Savino et al., 2007; Indrio et al., 2008).

Group Type ACTIVE_COMPARATOR

Lactobacillus Reuteri

Intervention Type DIETARY_SUPPLEMENT

L. reuteri DSM 17938 will be given at a dose of 1x108 colony forming units (CFU)/day

Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DIETARY_SUPPLEMENT

Placebo

Interventions

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Lactobacillus Reuteri

L. reuteri DSM 17938 will be given at a dose of 1x108 colony forming units (CFU)/day

Intervention Type DIETARY_SUPPLEMENT

Placebo

Placebo

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Gestational age 30 - 32 weeks. Gestational age will be defined by the best estimate based on prenatal ultrasound in the first trimester, DLM and/or Balard Score after birth.

Exclusion Criteria

* Cardiovascular or (respiratory) instability after 48 hours of age - Chromosomal anomalies.
* Major congenital anomalies (complex cardiac anomalies, congenital hydrocephalus, renal dysplasia)
* Congenital (e.g. jejunal atresia) and acquired (e.g. GI perforation) gastrointestinal pathology precluding oral feed and/or requiring major surgical or medical intervention
* Parental refusal
* Prior enrollment into a conflicting clinical trial. Conflicting clinical trial will be those in which the intervention could modify the outcome of the present study, for example studies that could alter the intestinal motility or the immune response of the premature infants.
Minimum Eligible Age

3 Days

Maximum Eligible Age

1 Month

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Bari

OTHER

Sponsor Role lead

Responsible Party

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Flavia Indrio

Principal Investigators

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Flavia Indrio

Role: PRINCIPAL_INVESTIGATOR

University of Bari

Locations

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Flavia Indrio

Bari, , Italy

Site Status

Countries

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Italy

Other Identifiers

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FI-LR2009

Identifier Type: -

Identifier Source: org_study_id