Single Vs Multi-strain Probiotics for Preterm Neonates

NCT ID: NCT07296718

Last Updated: 2025-12-22

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

PHASE4

Total Enrollment

249 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-15

Study Completion Date

2025-10-15

Brief Summary

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The goal of this randomized control clinical trial is to determine if probiotics can prevent mortality and morbidity in preterm neonates. It also evaluates effects of probiotics on feeding pattern and growth. It will also learn about the comparative effects of single vs multiple strain probiotics.

It aims to answer:

Does probiotics improve the health and growth outcomes in preterm neonates in our population? Does single vs multiple strain of probiotics have difference in effects?

Participants will:

Participants given either single strain or multiple strain probiotics for 28 days post birth.

Data about mortality, morbidity, feeding pattern and growth (weight, height, head circumference gain) recorded on daily basis.

Detailed Description

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This trial is single-centered, parallel, multi-arm, 1:1:1 randomized, blinded, placebo controlled clinical trial. It compares 3 groups; Group P1 (Placebo), Group P2-Single Strain probiotic (Lactobacillus rhamnosus GG) and Group P3- Multiple strains probiotic ( Bifidobacterium BB-12, Lactobacillus paracasei, L casei-431, Streptococcus thermophilus TH-4) for preventing preterm neonatal morbidities, improving feeding tolerance and overall growth.

Primary objective: The primary objective of our trial will be to compare the incidence and severity of Necrotizing enterocolitis (NEC) from the time of trial participation till the end of trial treatment (28 days) according to Bell's grading criteria.

Secondary objectives:

All these outcomes will be measured from the day intervention started to the end of supplementation (28 days)

* To evaluate incidence of sepsis, intracerebral haemorrhage and periventricular leukomalacia, retinopathy of prematurity and bronchopulmonary dysplasia)
* To estimate the time to full enteral feeding (i.e., ≥150 ml/kg/day) and feeding tolerance based on Davy's Neonatal Feeding Assessment Scale (NFAS).
* To determine the effect of probiotics on growth (weight, height, and head circumference) of premature babies
* To assess comparative efficacy of single strain vs combination probiotics for aforementioned objectives

Framework/hypothesis: The experimental group P2 (Lactobacillus rhamnosus GG) and Group P3- ( Bifidobacterium BB-12, Lactobacillus paracasei, L casei-431, Streptococcus thermophilus TH-4) are superior to control group (Placebo) as preventing NEC and other morbidities in preterm neonates, thus improving feeding tolerance and overall growth.

Conditions

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Necrotizing Enterocolitis of Newborn Sepsis Newborn Growth Feeding Intolerance

Keywords

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Probiotics Preterm neonates Single vs Multiple strain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Placebo-controlled randomized clinical trial
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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P1

1 ml of 10% dextrose water will be dispensed in 5cc syringe and administered orally or via feeding tube for 28 days.

Group Type PLACEBO_COMPARATOR

Dextrose 10%

Intervention Type DIETARY_SUPPLEMENT

P1

P2

Single strain probiotic- Lactobacillus rhamnosus GG. The single dose 1.5×109 CFU/day as 1 mL of the reconstituted solution will be given every day via the feeding tube or orally as applicable until reaching feeds of 50 mL/kg/day. It will be increased thereafter to 3×109 CFU/day once feeds exceed 50mL/kg/day.

Group Type ACTIVE_COMPARATOR

Lactobacillus Rhamnosus GG

Intervention Type DRUG

Single Strain

P3

Multiple strain probiotic-Bifidobacterium BB-12, Lactobacillus paracasei, L casei-431, Streptococcus thermophilus TH-4.

The single dose 1.5×109 CFU/day as 1 mL of the reconstituted solution will be given every day via the feeding tube or orally as applicable until reaching feeds of 50 mL/kg/day. It will be increased thereafter to 3×109 CFU/day once feeds exceed 50mL/kg/day.

Group Type ACTIVE_COMPARATOR

Bifidobacterium BB-12, Lactobacillus paracasei, L casei-431, Streptococcus thermophilus TH-4

Intervention Type DRUG

Multiple Strain

Interventions

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Dextrose 10%

P1

Intervention Type DIETARY_SUPPLEMENT

Lactobacillus Rhamnosus GG

Single Strain

Intervention Type DRUG

Bifidobacterium BB-12, Lactobacillus paracasei, L casei-431, Streptococcus thermophilus TH-4

Multiple Strain

Intervention Type DRUG

Other Intervention Names

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Placebo Prepro GG Amybact

Eligibility Criteria

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Inclusion Criteria

Preterm babies of gestational age \<35+6days, birth weight \<2500 grams, received and tolerated at-least one feed within 72 hours of birth and informed consent from parents or guardian.

Exclusion Criteria

* Neonates with major congenital malformations, gastrointestinal anomalies, early onset sepsis (C-reactive protein (CRP) \>10 mg/L in the first 72 h of life) and renal insufficiency
Maximum Eligible Age

36 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Madiha, MPhil

OTHER

Sponsor Role lead

Responsible Party

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Madiha, MPhil

Co-investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Imran Masood, PhD

Role: PRINCIPAL_INVESTIGATOR

The Islamia University of Bahawalpur, Khawaja Fareed Campus

Locations

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Bahawal Victoria Hospital

Bahawalpur, Punjab Province, Pakistan

Site Status

Countries

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Pakistan

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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NEOPRO-SvsM

Identifier Type: -

Identifier Source: org_study_id