Dietary supplements containing bacteria and yeasts which are potentially beneficial.

Marketed as dietary supplements.

Probiotics are defined as live micro organisms when administered in adequate amounts confer a health benefit on the host.

Postulated mechanisms of benefit of probiotics includes: enhance gut barrier function, competitive inhibition of pathogenic bacteria, and modulation of the host inflammatory response to pathogenic response.

Lactic acid bacteria are the most common organisms used.

Intended to assist the body to reestablish the natural flora.


Research shows that probiotics may offer benefits against a range of health conditions, including allergies, arthritis, asthma, cancer, depression, heart disease, and gastrointestinal problems.


Probiotics may even help with weight loss and cognitive function


For example, L. acidophilus has been shown to support healthy digestion and immune function, while B. longum blocks unfriendly bacteria and yeast.


Foods naturally loaded with probiotics: yogurt, kombucha, tempeh, miso, and sauerkraut all fermented foods.


The fermentation process creates probiotics.


Live microorganisms which when administered in adequate amounts confer a health benefit on the host.

Proposed mechanism of benefits include Saccharomyces boulardii, a strain of the yeast S. cerevisiae inhibits pathogenicity of bacterial toxins,

Lactic acid, propionic acid and acetic acid produced by Lactobacillus species could lower intestinal pH and inhibit growth of pathogenic bacteria such as E. coli and Clostridium species.

L. acidophilus may make the intestinal environment more acidic, supporting a natural balance of the fermentative processes.

Probiotics may physically or chemically prevent adhesion and colonization of pathogenic bacteria and may also induce immune responses.

Probiotics are proposed to reduce flatulence when used to restore balance to the normal intestinal flora.

Live (bioactive) yogurt contains, among other lactic bacteria, Lactobacillus acidophilus, which may be useful in reducing flatulence.

Yogurt is the most familial source of probiotics and must be made with Lactobacillus bulgaricus and Streptococcus thermophilus to be called yogurt.

Probiotics are available as dietary supplements, powders capsules, and liquids.

Yogurt intake does not improve health on basis of prospective study of 4445 Spanish adults followed for up to four years. (Lopez-Garcia et al).

The quality and quantity of bacteria and yeast and purity of yogurt products are uncertain.

Lactic acid bacteria (LAB) and bifidobacteria are the most common types of microbes used as probiotics.

Certain yeasts and bacilli may also be used.

Commonly consumed as part of fermented foods with specially added active live cultures; such as in yogurt, soy yogurt, or as dietary supplements.

Intended to maintain or restore gut microflora during or after antibiotic therapy by competition for receptors and nutrients, by inhibiting epithelial and mucosal adherence of bacterial pathogens, lowering colonic pH which allows growth of non pathogenic bacteria, immune activation, and by producing antimicrobial substances.

Meta-analyses and reviews indicate probiotics reduce the risk of antibiotic associated diarrhea by a relative risk reduction of 0.58 (Hempel S et al).

A 2018 Cochrane analysis concluded that in 10 of 14 systematic reviews of clinical trials, the data are insufficient to determine if probiotics improve specific gastrointestinal conditions.

Many trials suggest that probiotics can prevent or treat antibiotic associated diarrhea and Clostridium difficile infection, but other studies involving both children and adults have not shown such a benefit.

Some studies show that probiotics fail to colonize the guts of a proportion of participants, suggesting that bacteria may pass through some people with no effect.

Other studies show bacteria from probiotics take up residence in the intestines after a course of antibiotics, but they appear to delay the return of the native microbiota.

Prevention of antibiotic associated diarrhea base probiotic is Lactobacillus intervention either alone or in combination with other genera.

Use increases effectiveness of C.difficile infection treatment.

Co-administration of probiotics and antibiotics is associated with a lower risk for CDI versus placebo or no treatment.

Prophylactic probiotics result in a large reduction of Clostridium difficile associated diarrhea events.

Should be reserved for patients at highest risk for developing CDI and antibiotic associated diarrhea.

Probiotics have been used in the treatment of atopic dermatitis, lactose intolerance, bacterial vaginosis, asthma, allergic rhinitis, peptic ulcer disease associated with H. pylori infection.

Use may be associated with increased gas, diarrhea, bloating, and hiccoughs.

Infectious complications including sepsis with Lactobacillus casei, fungemia with Saccharomyces have been reported in highly immunosuppressed patients.

Should not be used in immunocompromised patients, in whom they have been associated with infections such as bacteremia.

A randomized trial involving 2556 healthy newborns enrolled in a  probiotic study found  decrease in the risk of sepsis and lower respiratory tract infections.

Providing probiotics shows that some individuals have a permissive G.I. tract that increases the number of probiotic strains in their intestinal lining, whereas others are resistant and their intestines do not significantly colonize.: One size fits all probiotic approach is probably incorrect and that some people may benefit from probiotics, while others may not.

Most probiotics have been shown to be safe in immunocompetent patients, but they have been implicated in infections among immunocompromised and critically ill patients.

A systemic review of probiotics to reduce antibiotic use for common infections in infants and children found that were use was associated with reduce risk of antibiotic prescription relative to placebo.

Among critically ill patients, randomized trials suggest probiotics reduce  infection rates by 20%,and may decrease the risk of ventilator associated pneumonia  by 25-30%.

Other reviews found that probiotics were associated with reduce duration of respiratory illness in children.

In a randomized trial probiotic agents compared with placebo did not significantly reduce antibiotic Administration over one year in older adults.

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