The Role of Probiotics in Nutritional Intake and Clinical Outcomes of Critically Ill Children With Severe Sepsis: A Double-Blind, Placebo-Controlled Trial Publisher Pubmed



Safabakhsh M ; Mohammadpour M ; Rohani P ; Ekbatani MS ; Pourhadi Z ; Imani H ; Shabbidar S
Source: Scientific Reports Published:2026

Abstract

We aimed to investigate the effect of probiotic supplementation on nutritional status and sepsis-associated nutritional complications in children with severe sepsis. In this study, 47 critically ill children with sepsis were randomly assigned to either the probiotic or the placebo group. The patients in the probiotic group received a sachet of probiotic twice daily, and those in the placebo group received corn starch daily for 1 week. The children in the probiotic group had a lower incidence of delayed start of nutrition (46% vs. 77%, P = 0.03) and sepsis-related gastrointestinal complications (9% vs. 36%, P = 0.03), especially for constipation (P = 0.02) and abdominal distension (P = 0.04) compared to the placebo group. Moreover, calorie intake achievement was shorter in the probiotic group than the placebo group (2.7 ± 0.8 days vs. 3.8 ± 1.0 days, P < 0.001). The probiotic group had remarkably higher mean calorie (44.3 ± 7.6 vs. 33.1 ± 10.5 kcal/kg daily, P = 0.01) and some micronutrient intake (P < 0.05). A significant improvement in Z-score for BMI in children > 2 years (0.35 ± 0.13 vs. -0.11 ± 0.18, P = 0.008) was observed after intervention. Probiotic administration may decrease the length of calorie goal achievement, delayed nutrition, and nutritional intolerance in children with sepsis. Well-designed multicenter clinical studies with defined combinations of probiotics and appropriate study lengths are necessary in this field. Trial Registration: Registered at the Iranian Registry of Clinical Trials (www.irct.ir) with the number IRCT20170202032367N10. Registration Date 15/08/2023. © The Author(s) 2026.