Commercial Powder and Ready-to-use Enteral Nutrition had better Accuracy in Energy and Macronutrients Content Compared to Homebrew.

Abstract

Background and Objective In Indonesia, homebrew, commercial powder and ready-to-use enteral formula have been used in hospital and at home. However, the decision to choose enteral formula is influenced by various things and often does not based on evidence-based practice. This study aims to compare macronutrient accuracy and microbial contamination status of homebrew, commercial powder and ready-to-use enteral formula. Furthermore, this result was expected to become a reference in deciding the enteral formula to use..Methods The design was a cross sectional comparative study. We collected 63 enteral nutrition samples from 7 different ICUs, wards and homes, in Jakarta from April to June 2012. Macronutrient accuracy was assessed by comparing energy, carbohydrate, protein and fat to their nutritional fact labels. The macronutrient accuracy was considered to be good if the deviation was <10% and bad if >10%. Microbial contamination was considered to be acceptable if the contamination in enteral formula by coliform was <3 MPN/mL, total plate count (TPC) <10 CFU/mL, and Staphylococcus aureus < 10 CFU/mL. Results Homebrew had bad accuracy in calorie, carbohydrate and fat; commercial powder enteral formula had slightly bad accuracy in fat; ready-to-use enteral formula had bad accuracy in carbohydrate and fat. There was no sample contaminated by Staphylococcus aureus. Contamination by coliform and TPC was most acceptable in ready-to-use enteral formula than others, and the least in homebrew. Conclusions Commercial and ready-to-use enteral nutrition are more acceptable than homebrew in macronutrients accuracy and microbial contamination status.