Probiotic Lactobacillus Acidophilus, Streptococcus Thermophilus, and Bifidobacterium Longum Effect on Bilirubin Levels of Neonates With Hyperbilirubinemia

ABSTRACT

Introduction: Hyperbilirubinemia, a prevalent condition in neonates, is associated with the potential for hospital readmission. Recent research has spotlighted probiotics as a promising alternative for mitigating bilirubin levels. This study aims to scrutinize the impact of probiotics, specifically Lactobacillus acidophilus, Streptococcus thermophilus, and Bifidobacterium longum, on bilirubin levels in neonates grappling with hyperbilirubinemia.

Objective: The primary objective of this study is to investigate the effects of the combination 0f phototeraphy with probiotic of Lactobacillus acidophilus, Streptococcus thermophilus, and Bifidobacterium longum on bilirubin levels in neonates with hyperbilirubinemia.

Methods: The study at RSI Sultan Agung Semarang used a prospective observational design with pre-post-test groups. Neonates hospitalized from August to November 2022 for hyperbilirubinemia were consecutively sampled. Licensing, ethical clearance, and data collection focused on hyperbilirubinemia status, routine blood tests, and mean bilirubin reduction. The control group received phototherapy, while the treatment group had phototherapy and probiotics (Lactobacillus acidophilus, Streptococcus thermophilus, and Bifidobacterium longum) for 7 days. SPSS software analyzed the data, using Paired T-Test or Wilcoxon test based on normality, with Mann Whitney test for group comparison (p<0.05)

.Results: The study assessed bilirubin levels in neonates with hyperbilirubinemia using the Shapiro-Wilk test for normality. While some variables showed non-normal distribution, the Wilcoxon non-parametric test revealed significant differences (p<0.05) in Total and Indirect Bilirubin within both control and treatment groups post-treatment. Direct Bilirubin did not exhibit a significant difference (p>0.05). The Mann-Whitney test demonstrated no significant difference (p>0.05) in mean values between the treatment group (receiving phototherapy and probiotics) and the control group. However in this study, it was found that there was a lower average decrease of total bilirubin and indirect bilirubin in the intervention group (6,50 mg/dl) ; (7,20 mg/dl) during the intervention period compared to the control group (6,70 mg/dl); (7,48 mg/dl). Although  Furthermore, the use of probiotics was identified as safe and well-tolerated among the study participants.

Conclusion: In conclusion, the findings suggest that the administration of probiotics, specifically Lactobacillus acidophilus, Streptococcus thermophilus, and Bifidobacterium longum, could serve as an adjuvant and safe alternative therapy for neonates grappling with hyperbilirubinemia. Although there is no significant difference compared to therapy using phototherapy alone, a faster average decrease was observed with phototherapy combined with Lactobacillus acidophilus, Streptococcus thermophilus, and Bifidobacterium longum . This has implications for the management and treatment of hyperbilirubinemia, potentially reducing the need for hospital readmissions.

Keywords: hyperbilirubinemia, neonates, probiotics, Lactobacillus acidophilus, Streptococcus thermophilus, Bifidobacterium longum.