Description

Use

Sufficient clinical trials have been conducted to enable meta-analyses for several clinical conditions. For specific probiotic strains in defined conditions, clear evidence has not yet been established.

There is evidence to support probiotic use in bacterial vaginosis, pediatric candidemia and candiduria, diarrhea (eg, acute infectious, antibiotic-associated, persistent), GI surgery, irritable bowel syndrome, necrotizing enterocolitis in neonates, upper respiratory tract infections (URTIs), blood pressure, and ventilator-associated pneumonia. Meta-analyses have shown no effect in asthma prevention, Crohn disease, eczema treatment, or ulcerative colitis with the use of probiotics, but there is equivocal evidence to support their use in the prevention of eczema, diabetes, and dyslipidemia, and in patients in intensive care.

Dosing

Daily intake of oral probiotic preparations is commonly recommended, but some trials have used twice-weekly dosing. Preparation strength is usually measured as million/billion colony-forming units (CFUs) per capsule.

Contraindications

Use of probiotics in severe acute pancreatitis is contraindicated. Use is also not advised in patients at risk of opportunistic infections and in those with badly damaged GI tracts.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking. Trials investigating probiotic use in pregnant women have not resulted in adverse reactions.

Interactions

None well documented