II. Definition

  1. Microorganisms taken as dietary supplements to help improve intestinal microbial balance

IV. Contraindications

  1. Severe immunompromised state
  2. Short-Gut Syndrome (relative contraindication)
  3. Some Probiotic preparations may contain gluten (avoid in Celiac Sprue)

V. Dosing

  1. Children: 5-10 Billion Colony Forming Units per day
  2. Adults: 10-20 Billion Colony Forming Units per day

VI. Components (most brands contain a mixture of multiple Probiotic strains)

  1. Lactobacillus species
    1. Lactobacillus acidophilus
    2. Lactobacillus rhamnosus
    3. Lactobacillus bulgaricus
  2. Bifidobacterium species
    1. Bifidobacterium bifidum
    2. Bifidobacterium longum
  3. Saccharomyces species

VII. Preparations

  1. Precautions
    1. Most significant factor affecting efficacy appears to be at least 5-10 Billion CFUs
    2. Specific organisms appear to have less of an impact on efficacy
  2. Activa yogurt (5-10 B CFU/container), Align (1 B CFU/cap)
    1. Bifidobacterium species
  3. Culturelle (10 B CFU/cap), Bio-K Plus (12.5 B CFU/cap), Bacid (1 B CFU/cap), Lactinex (1 M CFU/tab)
    1. Lactobacillus species
  4. DanActive yogurt drink (1 B CFU/3 oz)
    1. Lactobacillus species
    2. Streptococcus species
  5. Jamieson Probiotic Sticks (3 billion CFU/stick)
    1. Lactobacillus species
    2. Bifidobacterium species
  6. Iflora Multi-Biotic (16 B CFU/cap), Probiotic-10 (25 B CFU/cap)
    1. Lactobacillus species
    2. Streptococcus species
    3. Bifidobacterium species
  7. Kefir fermented milk drink (7-10 B CFU/8 oz)
    1. Bifidobacterium species
    2. Lactobacillus species
    3. Leuconostoc species
    4. Saccharomyces florentinus
  8. Florastor (1 B CFU/cap)
    1. Saccharomyces boulardii
  9. Garden of Life Raw Probiotics Ultimate Care (100 B CFU/cap)
    1. Bifidobacterium species
    2. Lactobacillus species
    3. Leuconostoc species
    4. Saccharomyces species
    5. Streptococcus species
    6. Additional 5 Bacteria distinct to this formulation (unknown efficacy)

VIII. Adverse Effects

  1. Flatulence
  2. Abdominal discomfort

IX. Drug Interactions

  1. None

X. Efficacy

  1. See Infantile Colic
  2. See Necrotizing Enterocolitis
  3. Antibiotic Associated Diarrhea significantly reduced if Probiotics started in first 3 days of antibiotics
    1. Prevents Antibiotic Associated Diarrhea (NNT 12) and Clostridium difficile (NNT 29)
    2. Probiotic examples: Bio-K+, Culturelle, DanActive, Florajen or Florastor
      1. Take 2 hours after each antibiotic dose
      2. Continue for up to 2 weeks after completing antibiotics
    3. Sazawal (2006) Lancet Infect Dis 6(6): 374-82 [PubMed]
    4. McFarland (2006) Am J Gastroenterol 101(4): 812-22 [PubMed]
  4. Acute Infectious Diarrhea reduced duration with Probiotics
    1. May shorten Diarrhea course by one day
    2. May also prevent Traveler's Diarrhea
    3. Canani (2007) BMJ 335(7615):340 [PubMed]
  5. Constipation
    1. Improves stooling frequency and symptoms in both children and adults with Functional Constipation
    2. Ford (2014) Am J Gastroenterol 109(10): 1547-61 [PubMed]
    3. Guerra (2011) World J Gastroenterol 17(34): 3916-21 [PubMed]
  6. Irritable Bowel Syndrome with reduced symptoms in women on Probiotics
    1. Whorwell (2006) Am J Gastroenterol 101(7): 1581-90 [PubMed]
  7. Ulcerative Colitis
    1. Increases remission rates with Ulcerative Colitis flares
    2. Shen (2014) Inflamm Bowel Dis 20(1): 21-35 [PubMed]
  8. Atopic Disease development risk may be reduced with Probiotics in infants
    1. Kalliomaki (2001) Lancet 357:1076-9 [PubMed]
  9. Other conditions with mixed or inconclusive data to support Probiotic use
    1. Helicobacter Pylori infection
    2. Hepatic Encephalopathy
    3. Nonalcoholic Steatohepatitis (NASH)

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Ontology: Probiotics (C0525033)

Definition (CHV) Live microbial DIETARY SUPPLEMENTS
Definition (NCI_NCI-GLOSS) A live microorganism used as a dietary supplement to help with digestion and normal bowel function. It may also help keep the gastrointestinal (GI) tract healthy. A bacterium found in yogurt called Lactobacillus acidophilus, is the most common probiotic.
Definition (MSH) Live microbial DIETARY SUPPLEMENTS which beneficially affect the host animal by improving its intestinal microbial balance. Antibiotics and other related compounds are not included in this definition. In humans, lactobacilli are commonly used as probiotics, either as single species or in mixed culture with other bacteria. Other genera that have been used are bifidobacteria and streptococci. (J. Nutr. 1995;125:1401-12)
Concepts Bacterium (T007)
MSH D019936
English Probiotics, PROBIOTIC, probiotics, probiotics (medication), Probiotic, probiotic
Swedish Probiotika
Czech probiotika
Finnish Probiootit
Russian PROBIOTIKI, ПРОБИОТИКИ
Polish Probiotyki
Croatian PROBIOTICI
Norwegian Probiotika
French Probiotiques
German Probiotika
Italian Probiotici
Dutch Probiotica
Portuguese Probióticos
Spanish Probióticos