Necrotizing EnterocolitisPhase 2NCT00616876
Lactulose Supplementation in Premature Infants
A Phase 2 study testing Lactulose and Dextrose in people with Necrotizing Enterocolitis and Sepsis, run by Bnai Zion Medical Center at 1 site in Israel.
Trial summary
A pilot study to test the safety of use of lactulose in preterm infants and to preliminary assess the hypothesis that lactulose would support the early growth of Lactobacilli in the stools of premature infants and possibly would also improve nutritional status and decrease NEC and late-onset sepsis. Read more about this study
- Who is it for?
- Ages 23 to 34 weeks
- Conditions the study is for
- Necrotizing Enterocolitis, Sepsis
- What is being tested?
- Lactulose and Dextrose
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 28 participants
- Where
- 1 siteIsrael
- Study dates
- Feb 2005to Jan 2007
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 23 to 34 weeks
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Premature infants were recruited based on the following criteria:
- 23-34 weeks' gestation (as determined by a combination of maternal dates, early prenatal ultrasonography and postnatal gestational age estimation based on physical and neuromuscular signs (New Ballard Score), as long as there will be gestational age agreement between the 3 methods < 2 weeks);
- Absence of major congenital malformations; and
- Informed consent obtained from parents.
Who cannot join
- Major congenital malformations and parental refusal.
Trial locations and contacts
1 site in 1 country.
Israel1 site
NICU, Department of Neonatology, Bnai Zion Medical Center
Haifa, 31048
About this study
Official title: The Effects of Lactulose Supplementation to Enteral Feedings in Premature Infants - A Pilot Study
A pilot study to test the safety of use of lactulose in preterm infants and to preliminary assess the hypothesis that lactulose would support the early growth of Lactobacilli in the stools of premature infants and possibly would also improve nutritional status and decrease NEC and late-onset sepsis.
Read the detailed description
Prospective, double-blind, placebo-controlled single center pilot study in 23-34 weeks gestation premature infants. Study group will receive 1% lactulose, while control group will receive 1% dextrose placebo in all their feeds (human milk or preterm formula). Clinical parameters will be followed. Stool samples will be sent for culture.
- Conditions
- Necrotizing Enterocolitis, Sepsis
- Being tested
- Lactulose, Dextrose
- Keywords
- lactulose, prebiotic, premature infant, enteral feeding, stools, lactobacillus, nutrition, growth
- Medical subject headings
- Enterocolitis, Necrotizing, Sepsis, Premature Birth
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
LactuloseDrug
Babies in the study group received lactulose in a dose of 1% in their entire mother's breast milk or preterm formula feeds (1 gram per 100 ml feeds, based on the daily volume of feeds, and evenly distributed between all the feeds for the entire duration of their hospital stay). 67% lactulose in the original preparation (Laevolac, Fresenius Kabi, Austria) was diluted by distilled water to 33.5% preparation in the pharmacy in strict sterile conditions under hood. Just before feeding the nurses added the required volume of this 33.5% lactulose solution to the ordered volume of feed to generate a final concentration of 1% lactulose in each feed.
DextroseDietary supplement
Babies in the control groups were given equal volumes of the comparable placebo in all their preterm formula feeds at final concentration of 1% dextrose. The 33.5% dextrose placebo solution was prepared by dissolving dextrose (Dextrose Pulv. USP.24/BP, Roquette Frores 6280, Lestrem, France) in distilled water under heat to the point of near boiling under the same strict sterile conditions in the pharmacy. This gave a placebo solution that looked similar in color, odor and liquidity to the study solution of 33.5% lactulose. Dark bottles were used to further blind the medical team as to what solution was the baby given.
| Study group | Role | What they receive |
|---|---|---|
| 1 | Experimental | Study group will receive 1% lactulose in all their feeds (human milk or preterm formula) Receives: Drug: Lactulose |
| 2 | Placebo comparator | Control group will receive 1% dextrose placebo in all their feeds (human milk or preterm formula). Receives: Dietary Supplement: Dextrose |
What is being measured
The primary outcome is the main question the study is designed to answer.
lactulose would support the early growth of Lactobacilli in the stools of premature infants
Measured: 1.5 years
Secondary outcomes (1)
lactulose would also improve nutritional status and decrease NEC and late-onset sepsis in preterm infants
Measured: 1.5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Feb 2008 (estimated)
- Study startFeb 2005
- Primary completionAug 2006
- Study completionJan 2007
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (39)Papers the sponsor has linked to this study.
- Other trials for Necrotizing EnterocolitisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 28 participants (actual)
Sponsor and investigators
- Lead sponsor
- Bnai Zion Medical Center
- Sponsor type
- Other government
- Investigators
- Arieh Riskin, MD, Principal investigator, Department of Neonatology, Bnai Zion Medical CenterRon Shaoul, MD, Principal investigator, Department of Pediatrics, Pediatric Gastroenterology, Bnai Zion Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00616876
- Sponsor's protocol ID
- BZ-23/04
- Other IDs
- LacPre18
- Status last verified
- Feb 2008
- First submitted
- 5 Feb 2008
- Last updated
- 15 Feb 2008
- Results posted
- No
- Data monitoring committee
- No
Publications
Rotimi VO, Duerden BI. The development of the bacterial flora in normal neonates. J Med Microbiol. 1981 Feb;14(1):51-62. doi: 10.1099/00222615-14-1-51.
PubMed 7463467Orrhage K, Nord CE. Factors controlling the bacterial colonization of the intestine in breastfed infants. Acta Paediatr Suppl. 1999 Aug;88(430):47-57. doi: 10.1111/j.1651-2227.1999.tb01300.x.
PubMed 10569223Benno Y, Sawada K, Mitsuoka T. The intestinal microflora of infants: composition of fecal flora in breast-fed and bottle-fed infants. Microbiol Immunol. 1984;28(9):975-86. doi: 10.1111/j.1348-0421.1984.tb00754.x.
PubMed 6513816Guarner F, Malagelada JR. Gut flora in health and disease. Lancet. 2003 Feb 8;361(9356):512-9. doi: 10.1016/S0140-6736(03)12489-0.
PubMed 12583961Vanderhoof JA, Young RJ. Probiotics in pediatrics. Pediatrics. 2002 May;109(5):956-8. doi: 10.1542/peds.109.5.956. No abstract available.
PubMed 11986461Bennet R, Eriksson M, Nord CE, Zetterstrom R. Fecal bacterial microflora of newborn infants during intensive care management and treatment with five antibiotic regimens. Pediatr Infect Dis. 1986 Sep-Oct;5(5):533-9. doi: 10.1097/00006454-198609000-00009.
PubMed 3763418Hall MA, Cole CB, Smith SL, Fuller R, Rolles CJ. Factors influencing the presence of faecal lactobacilli in early infancy. Arch Dis Child. 1990 Feb;65(2):185-8. doi: 10.1136/adc.65.2.185.
PubMed 2317064Sakata H, Yoshioka H, Fujita K. Development of the intestinal flora in very low birth weight infants compared to normal full-term newborns. Eur J Pediatr. 1985 Jul;144(2):186-90. doi: 10.1007/BF00451911.
PubMed 4043132Caicedo RA, Schanler RJ, Li N, Neu J. The developing intestinal ecosystem: implications for the neonate. Pediatr Res. 2005 Oct;58(4):625-8. doi: 10.1203/01.PDR.0000180533.09295.84.
PubMed 16189184Gewolb IH, Schwalbe RS, Taciak VL, Harrison TS, Panigrahi P. Stool microflora in extremely low birthweight infants. Arch Dis Child Fetal Neonatal Ed. 1999 May;80(3):F167-73. doi: 10.1136/fn.80.3.f167.
PubMed 10212075Gaynes RP, Edwards JR, Jarvis WR, Culver DH, Tolson JS, Martone WJ. Nosocomial infections among neonates in high-risk nurseries in the United States. National Nosocomial Infections Surveillance System. Pediatrics. 1996 Sep;98(3 Pt 1):357-61.
PubMed 8784356Millar M, Wilks M, Costeloe K. Probiotics for preterm infants? Arch Dis Child Fetal Neonatal Ed. 2003 Sep;88(5):F354-8. doi: 10.1136/fn.88.5.f354.
PubMed 12937036Neu J, Caicedo R. Probiotics: protecting the intestinal ecosystem? J Pediatr. 2005 Aug;147(2):143-6. doi: 10.1016/j.jpeds.2005.05.033. No abstract available.
PubMed 16126038Dani C, Biadaioli R, Bertini G, Martelli E, Rubaltelli FF. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol Neonate. 2002 Aug;82(2):103-8. doi: 10.1159/000063096.
PubMed 12169832Millar MR, Bacon C, Smith SL, Walker V, Hall MA. Enteral feeding of premature infants with Lactobacillus GG. Arch Dis Child. 1993 Nov;69(5 Spec No):483-7. doi: 10.1136/adc.69.5_spec_no.483.
PubMed 8285750
Study at a glance
From the registry record, last updated by the sponsor on 15 Feb 2008. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effects of Lactulose Supplementation to Enteral Feedings in Premature Infants - A Pilot Study
- ClinicalTrials.gov ID
- NCT00616876
- Acronym / sponsor ID
- BZ-23/04
- Conditions
- Necrotizing Enterocolitis, Sepsis
- Keywords
- lactulose, prebiotic, premature infant, enteral feeding, stools, lactobacillus, nutrition, growth
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 28 participants (actual)
- Lead sponsor
- Bnai Zion Medical CenterOther government
- Study start
- Feb 2005
- Primary completion
- Aug 2006 (actual)
- Study completion
- Jan 2007 (actual)
- First posted
- 15 Feb 2008 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A pilot study to test the safety of use of lactulose in preterm infants and to preliminary assess the hypothesis that lactulose would support the early growth of Lactobacilli in the stools of premature infants and possibly would also improve nutritional status and decrease NEC and late-onset sepsis.
Detailed description
Prospective, double-blind, placebo-controlled single center pilot study in 23-34 weeks gestation premature infants. Study group will receive 1% lactulose, while control group will receive 1% dextrose placebo in all their feeds (human milk or preterm formula). Clinical parameters will be followed. Stool samples will be sent for culture.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 1 | Experimental | Drug: LactuloseStudy group will receive 1% lactulose in all their feeds (human milk or preterm formula) |
| 2 | Placebo comparator | Dietary Supplement: DextroseControl group will receive 1% dextrose placebo in all their feeds (human milk or preterm formula). |
Who may qualify
- Ages
- 23 to 34 weeks
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (4 listed)
- 23-34 weeks' gestation (as determined by a combination of maternal dates, early prenatal ultrasonography and postnatal gestational age estimation based on physical and neuromuscular signs (New Ballard Score), as long as there will be gestational age agreement between the 3 methods < 2 weeks);
- Absence of major congenital malformations; and
- Informed consent obtained from parents.
Key exclusion criteria (1 listed)
- Major congenital malformations and parental refusal.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| LactuloseBabies in the study group received lactulose in a dose of 1% in their entire mother's breast milk or preterm formula feeds (1 gram per 100 ml feeds, based on the daily volume of feeds, and evenly distributed between all the feeds for the entire duration of their hospital stay). 67% lactulose in the original preparation (Laevolac, Fresenius Kabi, Austria) was diluted by distilled water to 33.5% preparation in the pharmacy in strict sterile conditions under hood. Just before feeding the nurses added the required volume of this 33.5% lactulose solution to the ordered volume of feed to generate a final concentration of 1% lactulose in each feed. | Drug | 1 |
| DextroseBabies in the control groups were given equal volumes of the comparable placebo in all their preterm formula feeds at final concentration of 1% dextrose. The 33.5% dextrose placebo solution was prepared by dissolving dextrose (Dextrose Pulv. USP.24/BP, Roquette Frores 6280, Lestrem, France) in distilled water under heat to the point of near boiling under the same strict sterile conditions in the pharmacy. This gave a placebo solution that looked similar in color, odor and liquidity to the study solution of 33.5% lactulose. Dark bottles were used to further blind the medical team as to what solution was the baby given. | Dietary supplement | 2 |
Primary outcome
lactulose would support the early growth of Lactobacilli in the stools of premature infants
Time frame: 1.5 years
1 secondary outcome
lactulose would also improve nutritional status and decrease NEC and late-onset sepsis in preterm infants
Time frame: 1.5 years
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Feb 2008.
- Background: PubMed 7463467Rotimi VO, Duerden BI. The development of the bacterial flora in normal neonates. J Med Microbiol. 1981 Feb;14(1):51-62. doi: 10.1099/00222615-14-1-51.
- Background: PubMed 10569223Orrhage K, Nord CE. Factors controlling the bacterial colonization of the intestine in breastfed infants. Acta Paediatr Suppl. 1999 Aug;88(430):47-57. doi: 10.1111/j.1651-2227.1999.tb01300.x.
- Background: PubMed 6513816Benno Y, Sawada K, Mitsuoka T. The intestinal microflora of infants: composition of fecal flora in breast-fed and bottle-fed infants. Microbiol Immunol. 1984;28(9):975-86. doi: 10.1111/j.1348-0421.1984.tb00754.x.
- Background: PubMed 12583961Guarner F, Malagelada JR. Gut flora in health and disease. Lancet. 2003 Feb 8;361(9356):512-9. doi: 10.1016/S0140-6736(03)12489-0.
- Background: PubMed 11986461Vanderhoof JA, Young RJ. Probiotics in pediatrics. Pediatrics. 2002 May;109(5):956-8. doi: 10.1542/peds.109.5.956. No abstract available.
- Background: PubMed 3763418Bennet R, Eriksson M, Nord CE, Zetterstrom R. Fecal bacterial microflora of newborn infants during intensive care management and treatment with five antibiotic regimens. Pediatr Infect Dis. 1986 Sep-Oct;5(5):533-9. doi: 10.1097/00006454-198609000-00009.
- Background: PubMed 2317064Hall MA, Cole CB, Smith SL, Fuller R, Rolles CJ. Factors influencing the presence of faecal lactobacilli in early infancy. Arch Dis Child. 1990 Feb;65(2):185-8. doi: 10.1136/adc.65.2.185.
- Background: PubMed 4043132Sakata H, Yoshioka H, Fujita K. Development of the intestinal flora in very low birth weight infants compared to normal full-term newborns. Eur J Pediatr. 1985 Jul;144(2):186-90. doi: 10.1007/BF00451911.
- Background: PubMed 16189184Caicedo RA, Schanler RJ, Li N, Neu J. The developing intestinal ecosystem: implications for the neonate. Pediatr Res. 2005 Oct;58(4):625-8. doi: 10.1203/01.PDR.0000180533.09295.84.
- Background: PubMed 10212075Gewolb IH, Schwalbe RS, Taciak VL, Harrison TS, Panigrahi P. Stool microflora in extremely low birthweight infants. Arch Dis Child Fetal Neonatal Ed. 1999 May;80(3):F167-73. doi: 10.1136/fn.80.3.f167.
- Background: PubMed 8784356Gaynes RP, Edwards JR, Jarvis WR, Culver DH, Tolson JS, Martone WJ. Nosocomial infections among neonates in high-risk nurseries in the United States. National Nosocomial Infections Surveillance System. Pediatrics. 1996 Sep;98(3 Pt 1):357-61.
- Background: PubMed 12937036Millar M, Wilks M, Costeloe K. Probiotics for preterm infants? Arch Dis Child Fetal Neonatal Ed. 2003 Sep;88(5):F354-8. doi: 10.1136/fn.88.5.f354.
Related trials for Necrotizing Enterocolitis
Active, not recruitingObservational study
Early Predictors of Necrotizing Enterocolitis in Neonates
Necrotizing Enterocolitis
Recruiting
Effects of Enteral Feeding Regimens on NEC, Mortality, and Neurodevelopment in Very Preterm Infants
Very Preterm Infant, Necrotizing Enterocolitis (NEC)
RecruitingObservational study
The Correlation Between Red Cell Transfusion and Complications of Prematurity
Retinopathy of Prematurity (ROP), Bronchopulmonary Dysplasia (BPD)
RecruitingPhase 1
Gut Permeability and Microbiome in Preterm Infants
Prematurity Complications
Recruiting
WithHolding Enteral Feeds Around Blood Transfusion (International)
Necrotizing Enterocolitis
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Arieh Riskin, MD principal investigator
Department of Neonatology, Bnai Zion Medical Center
Ron Shaoul, MD principal investigator
Department of Pediatrics, Pediatric Gastroenterology, Bnai Zion Medical Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Lactulose and Dextrose in people with Necrotizing Enterocolitis and Sepsis, run by Bnai Zion Medical Center at 1 site in Israel.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Feb 2008. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Israel. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
lactulose would support the early growth of Lactobacilli in the stools of premature infants (time frame: 1.5 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00616876, which also lists 39 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Feb 2008.