839 Evaluating probiotics usage in a level two local neonatal unit

• Published in: Archives of disease in childhood 2023-07, Vol.108 (Suppl 2), p.A163-A164
• Main Authors: Quaynor, Josephine, Abdurrazaq, Abdul, Karupaiah, ASHOK, Worsey, Sue, Tabassum, Shazia
• Format: Article
• Language: English
• Subjects: Clinical trials; Documentation; Enterocolitis; Gastroenterology; Guidelines; Hepatology; Infants; Intensive care; Likert Scales; Logical Thinking; Medical personnel; Necrotizing enterocolitis; Neonatal care; Neonates; Newborn babies; Nutrition; Pediatrics; Physicians; Premature babies; Premature Infants; Probiotics; Sepsis; Surveys; Young Children
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2023-rcpch.264

ObjectivesProbiotic usage in preterm infants is increasing worldwide. A number of randomised controlled trials on probiotics suggest that probiotics reduce rates of necrotising enterocolitis, late onset sepsis, and mortality. The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition has recently made recommendations on probiotic strains that have proven effective and measures to take before commencing probiotics in a neonatal unit. The main objective of this audit was to monitor compliance with the commencement and discontinuation of probiotics against local guidelines in a local neonatal unit.MethodsA retrospective audit was conducted over the 6-month period (February – July 2022). Probiotics (Proprems®) were offered to babies less than 32 weeks, or less than 1.5kgs in weight and on feeds of more than 20ml/kg/day. Administration of probiotics was by nurses. Data was collected viaanonymised survey completed by doctors working in the department.anonymised survey form completed by parents whose babies were commenced on probiotics.evidence of documentation on the commencement and discontinuation of probiotics in either the patient’s paper and/or electronic records (Badgernet).Data received was analysed with Likert scales and generated tables and charts.ResultsA total of 20 babies were started on probiotics over the 6-month period. All the patients (n=20; 100%) were started according to the local guidelines. 80% of the patients (n=16) were discontinued at 34 weeks. A total of 16 doctors responded with 81% (n=13) aware of the usage of probiotics in the unit. Just over half of the doctors (56% n= 9) were aware of when to commence and discontinue probiotics. Only 44% of the doctors (n=7) were conversant with how to prescribe probiotics. Ten responses were received from parents whose babies had been started on probiotics. All the parents (n=10; 100%) felt they easily understood the leaflet given to them prior to the commencement of probiotics. They also felt their concerns about probiotic usage were addressed appropriately.Recommendationsprocuring liquid form of the probiotics and direct addition to bolus feeds.including probiotic prescription writing to doctors’ induction program.encouraging clear documentation of probiotics start and end times.ConclusionThe audit showed good compliance against local guidelines regarding the commencement and discontinuation of probiotics. However, there was limited knowledge of probiotic prescribing among do