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ProPrems is a specific multi-strain probiotic formulation consisting of *Bifidobacterium infantis* (strain Bb-02), *Bifidobacterium lactis* (strain Bb-12), and *Streptococcus thermophilus* (strain TH-4). It was developed primarily for use in the ProPrems trial, a large-scale multicenter randomized controlled trial conducted in Australia and New Zealand to evaluate the efficacy of probiotics in preventing necrotizing enterocolitis (NEC) in very preterm infants (born at less than 32 weeks' gestation and weighing less than 1500g). The mechanism of action involves the competitive exclusion of pathogenic bacteria, enhancement of the intestinal epithelial barrier function, and modulation of the immature mucosal immune system. By establishing a healthy commensal microbiota, ProPrems aims to reduce the incidence of NEC and late-onset sepsis, which are significant causes of morbidity and mortality in the neonatal intensive care unit.
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