Lactobacillus acidophilus is a "friendly" strain of bacteria used to make yogurt and cheese. Although we are born without it, acidophilus soon establishes itself in our intestines and helps prevent intestinal infections. Acidophilus also flourishes in the vagina, where it protects women against yeast infections.
Acidophilus is one of several microbes known collectively as probiotics (literally, "pro life," indicating that they are bacteria and yeasts that help rather than harm). Others include the bacteria L. bulgaricus , L. reuteri , L. plantarum , L. casei , B. bifidus , S. salivarius , and S. thermophilus and the yeast Saccharomyces boulardii . Your digestive tract is like a rain forest ecosystem with billions of bacteria and yeasts rather than trees, frogs, and leopards. Some of these internal inhabitants are more helpful to your body than others. Acidophilus and related probiotics not only help the digestive tract function, they also reduce the presence of less healthful organisms by competing with them for the limited space available. For this reason, use of probiotics can help prevent infectious diarrhea.
Antibiotics can disturb the balance of your "inner rain forest" by killing friendly bacteria. When this happens, harmful bacteria and yeasts can move in and flourish. This can lead to vaginal yeast infections. Conversely, it appears that the regular use of probiotics can help prevent vaginal infections and generally improve the health of the gastrointestinal system. Whenever you take antibiotics, you should probably take probiotics as well and continue them for some time after you are done with the course of treatment.
Although we believe that they are helpful and perhaps even necessary for human health, we don't have a daily requirement for probiotic bacteria. They are living creatures, not chemicals, so they can sustain themselves in your body unless something comes along to damage them, such as antibiotics.
Cultured dairy products, such as yogurt and kefir, are good sources of acidophilus and other probiotic bacteria. Supplements are widely available in powder, liquid, capsule, or tablet form. Grocery stores and natural food stores both carry milk that contains live acidophilus. In addition to probiotics, related substances known as prebiotics may enhance the colonization of healthy bacteria in the intestinal tract. 140
Dosages of acidophilus are expressed not in grams or milligrams, but in billions of organisms. A typical daily dose should supply about 3 to 5 billion live organisms. Other probiotic bacteria are used similarly. The typical dose of S. boulardii yeast is 500 mg twice daily (standardized to provide 3 x 10 10 -colony-forming units per gram), to be taken while traveling or at the start of using antibiotics, and continued for a few days after antibiotics are stopped.
Because probiotics are not drugs, but rather living organisms that you are trying to transplant to your digestive tract, it is necessary to take the treatment regularly. Each time you do, you reinforce the beneficial bacterial colonies in your body, which may gradually push out harmful bacteria and yeasts growing there.
The downside of using a living organism is that probiotics may die on the shelf. In fact, a study reported in 1990 found that most acidophilus capsules on the market contained no living acidophilus. 1 The situation has improved in subsequent evaluations, but still some products are substandard. 99 The container label should guarantee living organisms at the time of purchase, not just at the time of manufacture. Another approach is to eat acidophilus-rich foods such as yogurt, in which the bacteria are most likely still alive.
To treat or prevent vaginal infections, mix 2 tablespoons of yogurt or the contents of a couple of capsules of acidophilus with warm water and use as a douche.
Finally, in addition to increasing your intake of probiotics, you can take fructo-oligosaccharides, supplements that can promote thriving colonies of helpful bacteria in the digestive tract. (Fructo-oligosaccharides are carbohydrates found in fruit. Fructo means "fruit," and an oligosaccharide is a type of carbohydrate.) Taking this supplement is like putting manure in a garden; it is thought to foster a healthy environment for the bacteria you want to have inside you. The typical daily dose of fructo-oligosaccharides is between 2 g and 8 g.
Evidence from many but not all double-blind, placebo-controlled trials suggests that probiotics may be helpful for many types of diarrhea , as well as for irritable bowel syndrome . 2 28,53-57,68,70,71,130,144,156,157,171,214,215,216,220,223
Probiotics may be helpful for controlling symptoms and maintaining remission in ulcerative colitis . 37-39,82,204,222 However, probiotics may be less useful for inducing remission; when probiotics were added to standard medications used for induction of remission, no additional benefits were seen in a study of people with mild-to-moderate ulcerative colitis. 155
Probiotics might help prevent colds , 43 possibly by improving immunity . 40-42,83,164 On a related note, one small, double-blind study found evidence that use of the probiotic bacteria Lactobacillus fermentum improved the effectiveness of the influenza vaccine. 135 (The probiotic supplement was taken in two doses. One was taken two weeks before the vaccine, and the other was taken two weeks after.)
Although probiotics are widely used to prevent or treat vaginal yeast infections ( Candida albicans ), evidence regarding potential benefit remains incomplete and inconsistent. 31-36,48,84-85 A small trial of 55 women with vulvovaginal candidiasis did demonstrate that daily Lactobacillus rhamnosus and L. reuteri supplementation for 4 weeks combined with single dose fluconazole (an anti-fungal medication) decreased symptoms compared to fluconazole alone. 202 Another large, well-designed trial, however, failed to find a Lactobacillus preparation helpful for preventing yeast infections caused by antibiotics. 86 One study did find that probiotics might reduce levels of Candida albicans in the mouth. 132
The bacteria Gardnerella vaginalis can cause a different type of vaginal infections ; as with vaginal yeast infections, probiotics have shown some promise for this condition, but evidence remains inconclusive. 145,158,175,190 A trial of 64 women taking a single dose of tinidazole for bacterial vaginosis suggests that women who also took daily probiotics capsules had better cure rates at 4 weeks. 195 A larger trial involving 120 women with a history of bacterial vagninosis found that taking one capsule daily of the probiotics Lactobacillus rhamnosus , acidophilus, and Streptococcus thermophilus reduced recurrence. 209
The bacteria Helicobacter pylori is the main cause of ulcers in the stomach and duodenum. Antibiotics can kill H. pylori , but more than one must be used at the same time, and, even then, the bacteria is not necessarily eradicated. Probiotics may be helpful. Evidence suggests that various probiotics can inhibit the growth of H. pylori . 65-67,87,169 While this effect does not appear to be strong enough for probiotic treatment to eradicate H. pylori on its own, preliminary evidence, including several small double-blind trials, suggest that various probiotics may help standard antibiotic therapy work better, reducing side effects and possibly increasing rate of eradication. 47,55,58,60,63,65,67,87,88, 97,98,131,148,149,162,185 For example, over a 2-week period, 82 adults with dyspepsia and H. pylori infection were randomized to receive lansoprazole (30 mg), amoxicillin (1,000 mg), clarithromycin (500 mg), plus kefir (a cultured dairy product rich in probiotics) or the medications plus placebo. Those in the kefir group experienced a better rate of H. pylori eradication and an improvement in their symptoms (eg, diarrhea, nausea, abdominal pain) compared to the placebo group. 217
Some, but not, all preliminary double-blind trials suggest that probiotics might improve cholesterol profile. 44-46,100-101,137 In addition, milk fermented by probiotics may slightly improve blood pressure levels. 104-106
Various probiotics might be helpful for allergic rhinitis (hay fever). 102-103,142 While there is some evidence that probiotics can help reduce symptoms of milk allergies, 49 one study found that adding probiotics to infant cow’s milk formula was not helpful. 176 One interesting study found that the use of probiotics during pregnancy and breastfeeding may decrease the likelihood that a highly allergic mother will pass her allergic tendencies to her breastfed infant. 180
One double-blind, placebo-controlled study of 70 people with chronic constipation found some evidence of benefit with Lactobacillus casei Shirota . 89 Another study found that Lactobacillus rhamnosus was helpful for chronic constipation in children. 141 A small trial also found benefits in children, this time with a mixture of bifidobacteria and lactobacilli . 151 In another study, a combination of B. lactis and B. longus showed promise for improving bowel regularity in nursing home residents. 146 Finally, in a 6-week double-blind, placebo-controlled trial of 274 people with constipation-predominant irritable bowel syndrome, use of a probiotic formula containing B. animalis significantly improved stool frequency. 144
A preliminary double-blind, placebo-controlled study found evidence that Lactobacillus GG might potentially be helpful for treating antibiotic-resistant bacteria. 138 This small study followed 23 people with severe kidney disease who tested positive for vancomycin-resistant bacteria in the stool. (Vancomycin is one of the main “last-ditch” antibiotics for treatment of resistant bacteria.) Use of a yogurt product containing L. rhamnosus appeared to be more effective at ridding the gastrointestinal tract of these bacteria than placebo. However, the study suffered from a number of flaws, especially its small size. Note also that participants in this study did not have active infection with antibiotic-resistant bacteria; they were carriers for it. Do not attempt to use probiotics as sole treatment for active infection with resistant bacteria.
On a related note, preventive use of probiotics does not appear to help prevent the development of resistant bacterial strains that may arise during antibiotic treatment. 96,111
One study found that giving probiotics to certain critically ill people could help prevent multiple organ failure. 133
One small, placebo-controlled study found that use of L. helveticus might improve sleep quality in seniors, for reasons that are not at all clear. 152
An open study found hints that probiotics might be helpful for mouth sores caused by Behcet’s syndrome. 147
As noted above, probiotics have shown some promise in the treatment of infections with the yeast Candida albicans . Probiotics are also proposed for the treatment of a theoretically related, but markedly controversial condition, known as yeast hypersensitivity syndrome (also known as chronic candidiasis, chronic candida, systemic candidiasis, or just candida ). As described by some alternative medicine practitioners, yeast hypersensitivity syndrome is a common problem that consists of a population explosion of the normally benign candida yeast that live in the vagina and elsewhere in the body, coupled with a type of allergic sensitivity to it. Probiotic supplements are widely recommended for this proposed condition because they establish large, healthy populations of friendly bacteria that compete with the candida that is trying to take up residence. However, there is no evidence that yeast hypersensitivity is a common problem, and virtually none that it exists at all.
Evidence for the effectiveness of probiotics in preventing urinary tract infections (UTI) has been mixed. A year-long open trial of 150 women, for example, failed to find Lactobacillus probiotics effective for preventing urinary tract infections as compared to cranberry juice or no treatment. 50 And a randomized trial involving 252 postmenopausal women found that Lactobacilli rhamnosus did not reduce the number of urinary tract infections compared to antibiotics. 226 Other studies, however, including a large (453-participant), 3-month, double-blind, placebo-controlled study of a special healthy E. coli probiotic, did find benefits. 107,175
A review of 9 randomized trials with 735 patients found that probiotics did not prevent recurrent UTIs in adults and children any better than no therapy, placebo, or other preventive methods.243
A substantial study failed to find a mixture of L. casei , L. bulgaricus , and S. thermophilus in yogurt and milk helpful for asthma in children. 142 But, another study found that the combination of a probiotic ( Bifidobacterium breve ) and a prebiotic (galacto/fructo-oligosaccharide) may help reduce wheezing in infants with eczema. 206
Probiotics have also been studied as possible treatment for liver disease . In one such study, 84 adults (aged 18-65) with liver disease ( cirrhosis or hepatitis ) were randomized to receive yogurt (1 cup, 3 times daily) with or without the probiotics B. bifidus , L. acidophilus , L. bulgaricus , and S. thermophilus . 212 After 2 weeks, the people in the probiotics group experienced an improvement in their symptoms (eg, improved food intake and appetite). Chronic liver disease with cirrhosis can lead to a potentially life-threatening brain abnormality, called hepatic encephalopathy. A 2011 review of 7 randomized trials involving 550 people found inconclusive evidence to support the use of probiotics as a treatment for this condition. 218
According to several studies, it appears that regular use of acidophilus and other probiotics can help prevent "traveler's diarrhea" (an illness caused by eating contaminated food, usually in developing countries). 4,12 One double-blind, placebo-controlled study followed 820 people traveling to southern Turkey, and found that use of Lactobacillus GG significantly protected against intestinal infection. 7
Other studies using S. boulardii have found similar benefits, 11,13,14 including a double-blind, placebo-controlled trial enrolling 3,000 Austrian travelers. 14 The greatest benefits were seen in travelers who visited North Africa and Turkey. The researchers noted that the benefit depended on consistent use of the product, and that a dosage of 1,000 mg daily was more effective than 250 mg daily.
Probiotics may also help prevent or treat acute infectious diarrhea in children and adults.
A 2001 review found 13 double-blind, placebo-controlled trials on the use of probiotics for acute infectious diarrhea in infants and children; 10 of these trials involved treatment and 3 involved prevention. 71 Overall, the evidence suggests that probiotics can significantly reduce the duration of diarrhea and perhaps help prevent it. The evidence is strongest for the probiotic Lactobacillus GG and for infection with a particular virus called rotavirus, which causes severe diarrhea in children.
Another more recent review of 63 trials involving over 8,000 people (mainly infants and children) found that probiotics reduced how long the episode of diarrhea lasted. 210 However, the authors concluded that more research needs to be done to determine which probiotics work best for infectious diarrhea.
And, in a subsequent smaller review focusing on persistent diarrhea (lasting for 2 weeks or longer), researchers concluded that probiotics are capable of reducing both the duration of the diarrhea episode as well as the stool frequency. 211 Another study that was part of this same review suggested that probiotics may help to reduce how long a child is hospitalized due to diarrhea.
One double-blind, placebo-controlled trial of 269 children (ages 1 month to 3 years) with acute diarrhea found that those treated with Lactobacillus GG recovered more quickly than those given placebo. 22 The best results were seen among children with rotavirus infection. Similar results with Lactobacillus GG were seen in a double-blind study of 71 children. 59 However, 224 young Chinese children with severe, acute diarrhea found no benefit from lactose-free formula supplemented with Bifidobacteria and S. thermophilus , suggesting that probiotics may not be as useful for cases of severe, dehydrating diarrhea. 170 Also, Lactobacillus rhamnosus GG is not always associated with improvement. When given for 10 days to 229 infants from rural India hospitalized with acute diarrhea it did not reduce the severity of the diarrhea during that time period. 198
In addition, a double-blind study evaluated the possible benefits of the probiotic L. reuteri in 66 children with rotavirus diarrhea. 5 The study found that treatment shortened the duration of symptoms, and the higher the dose, the better the effect. Similar benefits were seen in a placebo-controlled trial of 151 infants and children given the probiotic Escherichia coli Nissle 1917 (a safe strain of E. coli ) for 21 days for nonspecific (presumably viral) cases of mild to moderate diarrhea. 181 In another randomized trial of 74 children receiving oral rehydration solution for mild to moderate dehydration, L. reuteri reduced the frequency, duration, and relapse rate of acute diarrhea compared to placebo. 230
A double-blind, placebo-controlled study of 81 hospitalized children found that treatment with Lactobacillus GG reduced the risk of developing diarrhea, particularly rotavirus infection. 61 A double-blind, placebo-controlled study found that Lactobacillus GG helped prevent diarrhea in 204 undernourished children. 62
Other studies, though not entirely consistent, generally indicate that the probiotics B. bifidum , S. thermophilus, L. casei , Lactobacillus LB , and S. boulardii —both individually and combined with L. reuteri and L. rhamnosus —may also help prevent or treat diarrhea in infants and children. 8,9,11,15,23,26,56,57,92-93,108-109,150,183,220 One study found that bacteria in the B. bifidum family can kill numerous bacteria that cause diarrhea. 69
Researchers also studied whether adding Lactobacillus fermentum could have preventive benefits. 221 Two hundred and fifteen healthy infants were randomized to receive formula with prebiotics plus L. fermentum or the formula and prebiotics only. The infants in the L. fermentum group had fewer cases of gastrointestinal and upper respiratory infection.
Prophylactic use of probiotics was found to be effective at preventing C. difficile -induced diarrhea in a review of 20 randomized trials with 3,421 patients (including three trials with 605 children) when compared to placebo or no treatment. The most effective probiotics were S. boulardii and L. acidophilus combined with L. casei . 228
Keep in mind that diarrhea in young children can be serious. If it persists for more than a day, consult a physician.
A large (211-participant), double-blind, placebo-controlled study found that adults with diarrhea can benefit from probiotic treatment as well. 26 Another study found that regular use of probiotics could help prevent gastrointestinal infections in adults. 110
The results of many, but not all, double-blind and open trials suggest that probiotics, especially S. boulardii and Lactobacillus GG , may help prevent or treat antibiotic-related diarrhea. 10,11,16 18,25 28,75,76,94-95, 97-98,143,183,215 For example, one study evaluated 180 people, who received either placebo or 1,000 mg of saccharomyces daily along with their antibiotic treatment, and found that the treated group developed diarrhea significantly less often. 16 A similar study of 193 people also found benefit. 18 Three additional studies involving adults found that various species of Lactobacillus , taken either alone in combination, to be beneficial, 174,207 even in cases of Clostridium difficile , the most serious cause of antibiotic-induced diarrhea. 208
A review of 16 randomized trials further adds to this evidence. 219 This review included many different strains of probiotics (eg, Lactobacilli , Lactococcus , Bifidobacterium ), which were used alone or in combination. Bacteria that appeared to lack evidence of benefit included L. rhamnosus , L. sporogenes , B. lactis , and S. thermophilus . Like the earlier review, the pooled results of 34 randomized trials also found evidence to support the use of probiotics for the prevention of antibiotic-associated diarrhea in both children and adults. 225
On the other hand, a study of 302 people found no benefit with Lactobacillus GG . 25 And, a review of four probiotic studies found insufficient evidence for their effectiveness in the treatment of Clostridium difficile , the most serious cause of antibiotic-induced diarrhea. 159 Prophylactic use of Lactobacillus acidophilus LA-5 plus Bifidobacterium BB-12 (in combination with antibiotic treatment) was not associated with reduced incidence of diarrhea when compared to placebo. However, the probiotic reduced the duration time with diarrhea. 236
Although taking probiotic organisms in the proper concentration may be beneficial for antibiotic-induced diarrhea, at least one study found that consuming fresh yogurt during antibiotic treatments had no significant effect on the incidence of diarrhea. 160
Note: Diarrhea that occurs in the context of antibiotics may be dangerous; for this reason, physician consultation is essential.
Two double-blind, placebo-controlled studies enrolling a total of almost 700 people undergoing radiation therapy for cancer found that use of probiotics significantly improved radiation-induced diarrhea. 79,136 Similar evidence supports the use of Lactobacillus rhamnosus , 153 as well as a special, nonpathogenic form of E. coli . 78 However, of 85 women receiving pelvic radiation for cervical or uterine cancer, those who consumed a liquid yogurt preparation enriched with Lactobacillus casei had no less diarrhea than those who took a placebo drink. 161
Small double-blind studies suggest S. boulardii might be helpful for treating chronic diarrhea in people with HIV, hospitalized patients being tube-fed, and people with Crohn's disease. 11,19 21
Premature infants weighing less than 2,500 grams (5.5 pounds) are at risk for a life-threatening intestinal condition called necrotizing enterocolitis (NEC). In a study that pooled the results of 9 randomized, placebo-controlled trials involving 1,425 infants, probiotic supplementation significantly reduced the occurrence of NEC and death associated with it. 177 A subsequent study found similar benefits in very low birth weight infants weighing less than 1,500 grams (3.3 pounds). 189 For one probiotic strain, L. reuteri , there may be other benefits, as well. In another study involving 249 premature infants, those treated with L. reuteri experienced fewer gastrointestinal symptoms, received fewer antibiotics, and were hospitalized less frequently than those treated with L. rhamnosus or no probiotic. 213
Benefits of probiotics for NEC was further supported in three reviews that evaluated 24 randomized trials involving infants at risk of developing NEC. Prophylactic enteral probiotic supplementation was compared to placebo or no treatment in infants who were preterm (less than 37 weeks gestation), had low birth weight (2,500 grams or 5.5 pounds), or both. Probiotics were associated with reduced incidence of severe NEC in 20 trials with 5,529 infants, fewer infant deaths for any cause in 17 trials with 5,112 infants, and fewer infant deaths related to NEC in 7 trials with 2,755 infants. 235
A double-blind trial of 116 people with ulcerative colitis compared probiotic treatment against a relatively low dose of the standard drug mesalazine. 37 The results suggest that probiotic treatment might be equally effective as low-dose mesalazine for controlling symptoms and maintaining remission. Evidence of benefit was seen in other trials, as well. 38,82,112 For example, a 2011 review of 4 randomized trials with a total of 587 patients seemed to support the use of probiotics to reduce the relapse rates in people with ulcerative colitis. 222 The authors, though, pointed out the need for better designed trials.
One preliminary study found S. boulardii helpful for mild diarrhea in stable Crohn’s disease. 20 However, two studies failed to find benefit with Lactobacillus probiotics, 113-114 and in an analysis of 8 randomized, placebo-controlled studies, probiotics were ineffective at maintaining remission in Crohn’s disease patients. 165
Probiotics might be useful for people with ulcerative colitis who have had part or all of the colon removed. Such people frequently develop a complication called pouchitis, inflammation of part of the remaining intestine. A 9-month, double-blind trial of 40 people found that a combination of three probiotic bacteria could significantly reduce the risk of a pouchitis flare-up in people with chronic pouchitis. 39 Participants were given either placebo or a mixture of various probiotics, including four strains of Lactobacilli , three strains of Bifidobacteria , and one strain of Streptococcus salivarius . The results showed that treated people were far less likely to have relapses of pouchitis. Another study found that probiotics used right after surgery can help prevent pouchitis from developing at all. 80 One study, however, failed to find benefit with Lactobacillus johnsonii in people with Crohn’s disease who have undergone a similar operation. 129
Finally, some evidence hints that probiotics might reduce the joint pain that commonly occurs in people with either kind of inflammatory bowel disease. 115
People with irritable bowel syndrome (IBS) experience crampy digestive pain as well as alternating diarrhea and constipation and other symptoms. Although the cause of irritable bowel syndrome is not known, one possibility is a disturbance in healthy intestinal bacteria. Based on this theory, probiotics have been tried as a treatment for IBS, with some success.
For example, in a 6-week double-blind, placebo-controlled trial of 274 people with constipation-predominant irritable bowel syndrome, use of a probiotic formula containing Bifidobacterium animalis significantly reduced discomfort and increased stool frequency. 144 In another trial of 298 IBS patients, 8 weeks of treatment with beneficial Escherichia coli reduced typical symptoms compared to placebo. 200 In a review of 3 randomized trials, Lactobacillus rhamnosus GG was associated with improvement in symptom, especially a reduction in abdominal pain, among 393 children with IBS. 223 And finally, a 4-week randomized trial involving 122 people with IBS found evidence that B. bifidum improved symptoms and quality of life compared to placebo. 224
Benefits have also been seen in small, double-blind trials using L. plantarum , 2,53,70L. acidophilus , 3,163L. rhamnosus , 130L. salivarus and Bifidobacterium , 116,188 in addition to proprietary probiotic combinations including various strains. 54,117,156,187 One such combination, called VSL#3, contains B. longum , B. infantis , L. acidophilus , L. plantarum , L. casei , L. bulgaricus , and Streptococcus thermophilus . In a double-blind, crossover trial , 59 children aged 5-18 years old were randomized to receive VSL#3 or placebo for 6 weeks. 214 After a 2-week "wash-out" period, the children were switched to the other treatment. VSL#3 was associated with a reduction in symptoms, including abdominal pain, bloating, and gas. Benefits have also been seen with combination prebiotic /probiotic formulas 118, 182, 199 and prebiotics alone. 197
Of course, other studies have failed to find probiotics more effective than placebo. 68,119,172 One randomized trial involving 90 people with diarrhea-predominant IBS found Saccharomyces boulardii to be more effective than placebo at improving quality of life. 216 But, the probiotic did not seem to improve the actual symptoms of IBS. Two studies that pooled previous randomized trials on the use of probiotics for IBS came to similar conclusions: probiotics appear to offer some benefit, most notably for global symptoms and abdominal discomfort. However, these two studies were unable to determine which probiotic species were most effective. 178,179
Lactobacillus plantarum 299v failed to provide significant improvements in abdominal pain, bloating, or quality of life when compared to placebo in a randomized trial with 81 adults over an 8 week period. 239
Probiotics Lactobacillus, Bifidobacterium, Escherichia , and Streptococcus (alone or in combination) were evaluated in a review of 37 randomized trials. Priobiotics were associated with fewer global symptoms, abdominal pain, bloating, and flatulence when compared to placebo. There were no differences found in urgency-related symptoms. Although probiotic therapy appears effective, the right combination of strains remains unknown. 238
Use of probiotics during pregnancy and after childbirth may reduce risk of childhood eczema . In a very large, long-term, double-blind study, 1,223 pregnant women were given either placebo or a probiotic mixture (containing Lactobacilli and Bifidobacteria ) beginning 2-4 weeks before delivery. 125 Their newborn children then received either probiotics or placebo for six months. The results showed that the probiotics mixture markedly reduced the incidence of eczema (though not of other allergic diseases). However, in a follow-up to this study, researchers found that the probiotic supplementation was not associated with reduced eczema in children followed through age 5. The probiotics also had no effect on allergic rhinitis or asthma. 193
Another study also yielded marginal results, 139 and a third study involving only lactobacillus found no benefit at all for the prevention of eczema. This latter study actually demonstrated a modestly increased the risk of wheezing bronchitis in infants who took the probiotic. 168 But, some probiotics combined with prebiotics may help to reduce wheezing in infants with eczema. For example, Bifidobacterium breve and a galacto-/fructo-oligosaccharide mixture (Immunofortis) showed benefit in one randomized study involving 90 infants. 206
Bifidobacterium longum and Lactobacillus rhamnosus supplementation did not reduce incidence of eczema atopic dermatitis or allergic sensitization at 12 months among Asian infants at risk of allergic diseases. 196
Researchers in another study concluded that not all probiotics are created equal. In this placebo-controlled study involving pregnant women and their infants, Lactobacillus rhamnosus reduced the incidence of eczema in the children, but a strain of Bifidobacterium animalis did not. 186
Lactobacillus plantarum was effective in reducing the severity of eczema symptoms. The randomized trial included 118 children aged 1-13 years with eczema comparing L. plantarum to placebo for 12 weeks. 227
According to some but not all studies, infants who already have eczema may benefit from probiotics. 30,51,52,77,120-121,128,154,166 However, a careful review of 12 studies involving a total of 781 children found no convincing evidence that probiotics can effectively treat eczema in this age group. 191
If probiotics are beneficial for childhood eczema, they are probably more effective at preventing the condition rather than treating it. A carefully conducted review of numerous studies cautiously concluded that probiotics may help reduce the risk of eczema in infants and children, particularly those at high risk. 154 And two subsequent reviews found that probiotics were more effective at preventing childhood eczema, particularly when given both to mother (before birth) and infant. 166,173
A number of studies suggest that various probiotics can enhance immune function . One 12-week, double-blind, placebo-controlled trial evaluated 25 healthy elderly people, half of whom were given milk containing a particular strain of Bifidobacterium lactis , the others milk alone. 42 The results showed various changes in immune parameters which the researchers took as possibly indicating improved immune function. Another double-blind, placebo-controlled study of 50 people using B. lactis had similar results. 41
A 7-month, double-blind, placebo-controlled study of 571 children in daycare centers in Finland found that use of milk fortified with Lactobacillus GG reduced the number and severity of respiratory infections. 43 In another controlled trial, probiotics ( Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb-12) given daily to infants in their formula significantly reduced the risk of acute otitis media and recurrent respiratory infections during the first year of life compared to placebo. 192
Benefits were seen in three other large studies, in which probiotics combined with multivitamins and minerals helped prevent colds (or reduce their duration and severity) in adults. 122-124 However, a smaller and shorter study failed to find any effect on respiratory infections. 81 Similarly, Lactobacillus fermentum given to 20 healthy elite distance runners over a 4-month period during winter training was significantly more effective at reducing the number and severity of respiratory symptoms compared with a placebo. 164
One study found that Lactobacillus GG or L. acidophilus may improve the immune response to vaccinations. 83
A review of 13 randomized trials with 3,780 children, adults, and older adults compared different probiotics to either placebo or no treatment for prevention of colds. Probiotic use was associated with lower risk of number of colds and shorter duration of cold. Several types of probiotics were used in the trials, including: 240
An 8-week, double-blind, placebo-controlled trial of 70 overweight people found that a probiotic treatment containing S. thermophilus and Enterococcus faecium could reduce LDL ("bad") cholesterol by about 8%. 45 Similarly positive results were seen in other short-term trials of various probiotics. 44,46,73,74,100-101 However, a 6-month, double-blind, placebo-controlled trial found no long-term benefit. 72 Researchers speculate that participants stopped using the product regularly toward the later parts of the study.
The addition of the probiotic Lactobacillus rhamnosus to regular was no better than than placebo in 77 patients with chronic rhinosinusitis. 201
Critical illnesses can result in changes to gut bacteria, leading to a loss of healthy bacteria and overgrowth of harmful bacteria. This change in bacteria may affect the immune system, affecting overall health. Certain strains of probiotics may restore balance to the to the intestinal tract, which can help with overall immunity. Probiotics were analyzed in 2 reviews of 31 randomized trial with 3,236 critically ill patients. When compared to placebo or no treatment, probiotics were associated with fewer cases of ventilator-associated pneumonia (VAP), less risk of VAP, and other serious complications resulting from infection. Some data suggested probiotics may also be connected to fewer intensive care deaths. Although the results of these reviews are promising, more research needs to be done to make firm conclusions. 237
A review of 25 randomized trials with 2,971 infants did not find sufficient evidence to support supplementation of infant formula with synbiotics, probiotics, or prebiotics. There were no significant effects on growth, crying, colic, regurgitation, or restlessness compared to conventional infant formula. Synbiotics and prebiotics were associated with increased stool frequency.
Probiotics may play a role in balancing bacteria in the gut, but not all probiotics may be helpful.
A randomized trial of 82 breastfed infants with colic compared supplementation with oral Lactobacillus reuteri (L. reuteri) to placebo for 21 days. A reduction in more that 50% in mean crying time was seen in all infants who received L. reuteri compared to 63% of infants in placebo group. L. reuteri supplement and was also associated with a larger decrease in the amount of daily crying and better family quality of life scores. 231
In another randomized trial of 50 exclusively breastfed infants with colic, supplementation with L. reuteri for 21 days was associated with a 50% reduction in daily crying time when compared with placebo. 234
A second randomized trial with 90 infants found a similar decrease in crying time with L. reuteri , but there were no significant differences in crying time found in a small trial of 18 infants when Lactobacillus rhamnosus and Propionibacterium freudenreichii were compared to placebo. 232
L. reuteri was also found to have significantly better reduction in crying time compared to simethicone in randomized trial of 82 infants with colic. After 28 days, median crying time was reduced from 197 minutes a day to 51 minutes a day with L. reuteri supplemention compared to 145 minutes a day with simethicone. Crying time decreased by 50% or more in 95% of infants taking L. reuteri compared to 7% of infants taking simethicone. 233
However, L. reuteri in formula-fed infants 6 weeks old or less had the opposite effect. The probiotic was associated with an increase in fussing time (not crying, but awake and not content) compared to placebo. Probiotics were used for one month and the infants were followed for six months. L. reuteri showed no benefit for infants that were exclusively breastfed. 241
Probiotics may occasionally cause a temporary increase in digestive gas. But, beyond that, they do not present any known risks for most people. In one trial of 140 healthy infants, formula supplemented with long-chain polyunsaturated fatty acids and probiotics appeared as safe as standard formula, and did not have any effect on infant growth by the end of the 7-month trial. 194
However, individuals who are immunosuppressed could conceivably be at risk for developing a dangerous infection with the probiotic organism itself; at least one person taking immunosuppressive medications has died in this manner. 31
In a detailed review of four studies, researchers concluded that the use probiotics did not benefit patients with severe acute pancreatitis. 184 Furthermore, according to one study, the use of probiotics led to an increased risk of mortality in patients with severe acute pancreatitis, and should, therefore, be avoided under these circumstances. 167
2. Nobaek S, Johansson M-L, Molin G, et al. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol. 2000;95:1231-1238.
8. Saavedra JM, Bauman NA, Oung I, et al. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet. 1994;344:1046-1049.
9. Pedone CA, Bernabeu AO, Postaire ER, et al. The effect of supplementation with milk fermented by Lactobacillus casei (strain DN-114 001) on acute diarrhoea in children attending day care centres. Int J Clin Pract. 1999;53:179-184.
14. Kollaritsch VH, Holst H, Grobara P, et al. Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a placebo-controlled double-blind study [translated from German]. Fortschr Med. 1993;111:152-156.
19. Bleichner G, Blehaut H, Mentec H, et al. Saccharomyces boulardii prevents diarrhea in critically ill tube-fed patients. A multicenter, randomized, double-blind placebo-controlled trial. Intensive Care Med. 1997;23:517-523.
20. Plein K, Hotz J. Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn's disease with special respect to chronic diarrhea—a pilot study. Z Gastroenterol. 1993;31:129-134.
22. Guandalini S, Pensabene L, Zikri MA, et al. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial. J Pediatr Gastroenterol Nutr. 2000;30:54-60.
23. Simakachorn N, Pichaipat V, Rithipornpaisarn P, et al. Clinical evaluation of the addition of lyophilized, heat-killed Lactobacillus acidophilus LB to oral rehydration therapy in the treatment of acute diarrhea in children. J Pediatr Gastroenterol Nutr. 2000;30:68-72.
24. Armuzzi A, Cremonini F, Ojetti V, et al. Effect of Lactobacillus GG supplementation on antibiotic-associated gastrointestinal side effects during Helicobacter pylori eradication therapy: a pilot study. Digestion. 2001;63:1-7.
39. Gionchetti P, Rizzello F, Venturi A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology. 2000;119:305-309.
42. Chiang BL, Sheih YH, Wang LH, et al. Enhancing immunity by dietary consumption of a probiotic lactic acid bacterium ( Bifidobacterium lactis HN019): optimization and definition of cellular immune responses. Eur J Clin Nutr. 2000;54:849-855.
48. Reid G, Charbonneau D, Erb J, et al. Oral use of Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS Immunol Med Microbiol. 2003;35:131-134.
49. Pelto L, Isolauri E, Lilius EM, et al. Probiotic bacteria down-regulate the milk-induced inflammatory response in milk-hypersensitive subjects but have an immunostimulatory effect in healthy subjects. Clin Exp Allergy. 1998;28:1474-1479.
50. Kontiokari T, Sundqvist K, Nuutinen M, et al. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for the prevention of urinary tract infections in women. BMJ. 2001;322:1-5.
54. Kim HJ, Camilleri M, McKinzie S, et al. A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther. 2003;17:895-904.
55. Cremonini F, Di Caro S, Covino M, et al. Effect of different probiotic preparations on anti- Helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol. 2002;97:2744-2749.
60. De Francesco V, Stoppino V, Sgarro C, et al. Lactobacillus acidophilus administration added to omeprazole/amoxycillin-based double therapy in Helicobacter pylori eradication. Dig Liver Dis. 2000;32:746-747.
63. Canducci F, Armuzzi A, Cremonini F, et al. A lyophilized and inactivated culture of Lactobacillus acidophilus increases Helicobacter pylori eradication rates. Aliment Pharmacol Ther. 2000;14:1625-1629.
64. Armuzzi A, Cremonini F, Bartolozzi F, et al. The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther. 2001;15:163-169.
65. Michetti P, Dorta G, Wiesel PH, et al. Effect of whey-based culture supernatant of Lactobacillus acidophilus ( johnsonii ) La1 on Helicobacter pylori infection in humans Digestion. 1999;60:203-209.
67. Aiba Y, Suzuki N, Kabir AM, et al. Lactic acid-mediated suppression of Helicobacter pylori by the oral administration of Lactobacillus salivarius as a probiotic in a gnotobiotic murine model. Am J Gastroenterol. 1998;93:2097-2101.
70. Niedzielin K, Kordecki H, Birkenfeld B. A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2001;13:1143-1147.
71. Szajewska H, Mrukowicz JZ. Probiotics in the treatment and prevention of acute infectious diarrhea in infants and children: a systematic review of published randomized, double-blind, placebo-controlled trials. J Pediatr Gastroenterol Nutr. 2001;33(suppl 4):S17-S25.
72. Richelsen B, Kristensen K, Pedersen SB. Long-term (6 months) effect of a new fermented milk product on the level of plasma lipoproteins—a placebo-controlled and double blind study. Eur J Clin Nutr. 1996;50:811-815.
78. Unger C, Haring B, Kruse A, et al. Double-blind randomised placebo-controlled phase III study of an E. coli extract plus 5-fluorouracil versus 5-fluorouracil in patients with advanced colorectal cancer. Arzneimittelforschung. 2001;51:332-338.
79. Urbancsek H, Kazar T, Mezes I, et al. Results of a double-blind, randomized study to evaluate the efficacy and safety of Antibiophilus in patients with radiation-induced diarrhoea. Eur J Gastroenterol Hepatol. 2001;13:391-396.
82. Kato K, Mizuno S, Umesaki Y, et al. Randomized placebo-controlled trial assessing the effect of bifidobacteria-fermented milk on active ulcerative colitis. Aliment Pharmacol Ther. 2004;20:1133-1141.
87. Pantoflickova D, Corthesy-Theulaz I, Dorta G, et al. Favourable effect of regular intake of fermented milk containing Lactobacillus johnsonii on Helicobacter pylori associated gastritis. Aliment Pharmacol Ther. 2003;18:805-814.
89. Koebnick C, Wagner I, Leitzmann P, et al. Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation. Can J Gastroenterol. 2003;17:655-659.
92. Thibault H, Aubert-Jacquin C, Goulet O. Effects of long-term consumption of a fermented infant formula (with Bifidobacterium breve c50 and Streptococcus thermophilus on acute diarrhea in healthy infants. J Pediatr Gastroenterol Nutr. 2004;39:147-152.
93. Salazar-Lindo E, Miranda-Langschwager P, Campos-Sanchez M, et al. Lactobacillus casei strain GG in the treatment of infants with acute watery diarrhea: a randomized, double-blind, placebo controlled clinical trial. BMC Pediatr. 2004 Sep 2. [Epub ahead of print]
94. Wullt M, Hagslatt ML, Odenholt I. Lactobacillus plantarum 299v for the treatment of recurrent Clostridium difficile -associated diarrhoea: a double-blind, placebo-controlled trial. Scand J Infect Dis. 2003;35:365-367.
96. Sullivan A, Johansson A, Svenungsson B, et al. Effect of Lactobacillus F19 on the emergence of antibiotic-resistant microorganisms in the intestinal microflora. J Antimicrob Chemother. 2004 Aug 25. [Epub ahead of print]
97. Myllyluoma E, Veijola L, Ahlroos T, et al. Probiotic supplementation improves tolerance to Helicobacter pylori eradication therapy - a placebo-controlled, double-blind randomized pilot study. Aliment Pharmacol Ther. 2005;21:1263-1272.
98. Duman DG, Bor S, Ozutemiz O, et al. Efficacy and safety of Saccharomyces boulardii in prevention of antibiotic-associated diarrhoea due to Helicobacterpylori eradication. Eur J Gastroenterol Hepatol. 2005;17:1357-1361.
99. Product review: probiotic supplements and foods (including lactobacillus acidophilus and bifidobacterium ). ConsumerLab website. Available at: http://www.consumerlab.com/results/probiotics.asp . Accessed May 26, 2006.
102. Ishida Y, Nakamura F, Kanzato H, et al. Clinical Effects of Lactobacillus acidophilus Strain L-92 on Perennial Allergic Rhinitis: A Double-Blind, Placebo-Controlled Study. J Dairy Sci. 2005;88:527-533.
103. Ishida Y, Nakamura F, Kanzato H, et al. Effect of milk fermented with lactobacillus acidophilus strain L-92 on symptoms of Japanese cedar pollen allergy: a randomized placebo-controlled trial. Biosci Biotechnol Biochem. 2005;69:1652-1660.
104. Jauhiainen T, Vapaatalo H, Poussa T, et al. Lactobacillus helveticus fermented milk lowers blood pressure in hypertensive subjects in 24-h ambulatory blood pressure measurement. Am J Hypertens. 2005;18:1600-1605.
107. Bauer HW, Alloussi S, Egger G, et al. A long-term, multicenter, double-blind study of an escherichia coli extract (OM-89) in female patients with recurrent urinary tract infections. Eur Urol. 2005;47:542-548.
109. Kotowska M, Albrecht P, Szajewska H, et al. Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: a randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther. 2005;21:583-590.
110. Tubelius P, Stan V, Zachrisson A, et al. Increasing work-place healthiness with the probiotic Lactobacillus reuteri: A randomised, double-blind placebo-controlled study. Environ Health. 2005 Nov 7. [Epub ahead of print]
111. Plummer SF, Garaiova I, Sarvotham T, et al. Effects of probiotics on the composition of the intestinal microbiota following antibiotic therapy. Int J Antimicrob Agents. 2005 Jun 17. [Epub ahead of print]
112. Furrie E, Macfarlane S, Kennedy A, et al. Synbiotic therapy (Bifidobacterium longum/Synergy 1) initiates resolution of inflammation in patients with active ulcerative colitis: a randomised controlled pilot trial. Gut. 2005;54:242-249
113. Bousvaros A, Guandalini S, Baldassano RN, et al. A randomized, double-blind trial of Lactobacillus GG versus placebo in sddition to standard maintenance therapy for children with Crohn's disease. Inflamm Bowel Dis. 2005;11:833-839.
114. Marteau P, Lemann M, Seksik P, et al. Ineffectiveness of Lactobacillus johnsonii LA1 for prophylaxis of postoperative recurrence in Crohn's disease: a randomised, double-blind, placebo-controlled GETAID trial. Gut. 2005 Dec 23. [Epub ahead of print]
117. Kim HJ, Vazquez Roque MI, Camilleri M, et al. A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating. Neurogastroenterol Motil. 2005;17:687-696.
118. Bittner AC, Croffut RM, Stranahan MC, et al. Prescript-Assist probiotic-prebiotic treatment for irritable bowel syndrome: a methodologically oriented, 2-week, randomized, placebo-controlled, double-blind clinical study. Clin Ther. 2005;27:755-761.
119. Niv E, Naftali T, Hallak R, et al. The efficacy of Lactobacillus reuteri ATCC 55730 in the treatment of patients with irritable bowel syndrome-a double blind, placebo-controlled, randomized study. Clin Nutr. 2005 Jul 26. [Epub ahead of print].
122. Tubelius P, Stan V, Zachrisson A, et al. Increasing work-place healthiness with the probiotic Lactobacillus reuteri: A randomised, double-blind placebo-controlled study. Environ Health. 2005 Nov 7. [Epub ahead of print]
123. de Vrese M, Winkler P, Rautenberg P, et al. Effect of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 on common cold episodes: A double blind, randomized, controlled trial. Clin Nutr. 2005;24:481-491.
124. Winkler P, de Vrese M, Laue C, et al. Effect of a dietary supplement containing probiotic bacteria plus vitamins and minerals on common cold infections and cellular immune parameters. Int J Clin Pharmacol Ther. 2005;43:318-26.
125. Kukkonen K, Savilahti E, Haahtela T, et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: A randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol. 2006 Oct 27. [Epub ahead of print]
126. Folster-Holst R, Muller F, Schnopp N, et al. Prospective, randomized controlled trial on Lactobacillus rhamnosus in infants with moderate to severe atopic dermatitis. Br J Dermatol. 2006;155:1256-1261.
127. Tamura M, Shikina T, Morihana T, et al. Effects of probiotics on allergic rhinitis induced by Japanese cedar pollen: randomized, double-blind, placebo-controlled clinical trial. Int Arch Allergy Immunol. 2006 Dec 29. [Epub ahead of print]
128. Taylor AL, Dunstan JA, Prescott SL. Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial. J Allergy Clin Immunol. 2007;119:184-191.
129. Van Gossum A, Dewit O, Louis E, et al. Multicenter randomized-controlled clinical trial of probiotics ( Lactobacillus johnsonii , LA1) on early endoscopic recurrence of Crohn's disease after ileo-caecal resection. Inflamm Bowel Dis. 2006 Dec 19. [Epub ahead of print]
130. Gawronska A, Dziechciarz P, Horvath A, et al. A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children. Aliment Pharmacol Ther. 2007;25:177-84.
131. Tong JL, Ran ZH, Shen J, et al. Meta-analysis: the effect of supplementation with probiotics on eradication rates and adverse events during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther. 2007;25:155-168.
134. Hatakka K, Blomgren K, Pohjavuori S, et al. Treatment of acute otitis media with probiotics in otitis-prone children: a double-blind, placebo-controlled randomised study. Clin Nutr. 2007 Mar 10. [Epub ahead of print]
139. Abrahamsson TR, Jakobsson T, Bottcher MF, et al. Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol. 2007;119:1174-1180.
142. Giovannini M, Agostoni C, Riva E, et al. A randomized prospective double blind controlled trial on effects of long-term consumption of fermented milk containing Lactobacillus casei in pre-school children with allergic asthma and/or rhinitis. Pediatr Res. 2007 Jun 25. [Epub ahead of print]
143. Hickson M, D'Souza AL, Muthu N, et al. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ. 2007 Jun 29. [Epub ahead of print]
144. Guyonnet D, Chassany O, Ducrotte P, et al. Effect of a fermented milk containing Bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care: a multicentre, randomized, double-blind, controlled trial. Aliment Pharmacol Ther. 2007;26:475-486.
146. Pitkala KH, Strandberg TE, Finne Soveri UH, et al. Fermented cereal with specific bifidobacteria normalizes bowel movements in elderly nursing home residents. A randomized, controlled trial. J Nutr Health Aging. 2007;11:305-311.
148. Cindoruk M, Erkan G, Karakan T, et al. Efficacy and safety of saccharomyces boulardii in the 14-day triple anti-helicobacter pylori therapy: A prospective randomized placebo-controlled double-blind study. Helicobacter. 2007;12:309-136.
149. Imase K, Tanaka A, Tokunaga K, et al. Lactobacillus reuteri tablets suppress Helicobacter pylori infection—a double-blind randomised placebo-controlled cross-over clinical study. Kansenshogaku Zasshi. 2007;81:387-393.
152. Yamamura S, Morishima H, Kumano-Go T, et al. The effect of Lactobacillus helveticus fermented milk on sleep and health perception in elderly subjects. Eur J Clin Nutr. 2007 Sep 12. [Epub ahead of print]
153. Osterlund P, Ruotsalainen T, Korpela R, et al. Lactobacillus supplementation for diarrhea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer. 2007 Sep 25. [Epub ahead of print]
156. Kajander K, Myllyluoma E, Rajilic-Stojanovic M, et al. Clinical trial: multispecies probiotic supplementation alleviates the symptoms of IBS and stabilises intestinal microbiota. Aliment Pharmacol Ther. 2007 Oct 6. [Epub ahead of print]
157. Beausoleil M, Fortier N, Guenette S, et al. Effect of a fermented milk combining lactobacillus acidophilus Cl1285 and lactobacillus casei in the prevention of antibiotic-associated diarrhea: A randomized, double-blind, placebo-controlled trial. Can J Gastroenterol. 2007;21:732-736.
158. Larsson PG, Stray-Pedersen B, Ryttig KR, et al. Human lactobacilli as supplementation of clindamycin to patients with bacterial vaginosis reduce the recurrence rate; a 6-month, double-blind, randomized, placebo-controlled study. BMC Womens Health. 2008 Jan 15.
160. Conway S, Hart A, Clark A, et al. Does eating yogurt prevent antibiotic-associated diarrhoea? A placebo-controlled randomised controlled trial in general practice. Br J Gen Pract. 2007;57:953-959.
161. Giralt J, Regadera JP, Verges R, et al. Effects of Probiotic Lactobacillus casei DN-114 001 in prevention of radiation-induced diarrhea: results from multicenter, randomized, placebo-controlled nutritional trial. Int J Radiat Oncol Biol Phys. 2008 Feb 1.
165. Rahimi R, Nikfar S, Rahimi F, et al. A meta-analysis on the efficacy of probiotics for maintenance of remission and prevention of clinical and endoscopic relapse in Crohn's disease. Dig Dis Sci. 2008 Feb 14.
168. Kopp MV, Hennemuth I, Heinzmann A, et al. Randomized, double-blind, placebo-controlled trial of probiotics for primary prevention: no clinical effects of lactobacillus GG supplementation. Pediatrics. 2008 Mar 10.
172. Drouault-Holowacz S, Bieuvelet S, Burckel A, et al. A double blind randomized controlled trial of a probiotic combination in 100 patients with irritable bowel syndrome. Gastroenterol Clin Biol. 2008;32:147-52.
174. Ruszczynski M, Radzikowski A, Szajewska H. Clinical trial: effectiveness of Lactobacillus rhamnosus (strains E/N, Oxy, and Pen) in the prevention of antibiotic-associated diarrhea in children. Aliment Pharmacol Ther. 2008 Apr 13.
176. Hol J, van Leer EH, Elink Schuurman BE, et al. The acquisition of tolerance toward cow's milk through probiotic supplementation: A randomized controlled trial. J Allergy Clin Immunol. 2008 Apr 22.
180. Huurre A, Laitinen K, Rautava S, et al. Impact of maternal atopy and probiotic supplementation during pregnancy on infant sensitization: a double-blind placebo-controlled study. Clin Exp Allergy. 2008 May 7.
181. Henker J, Laass MW, Blokhin BM, et al. Placebo versus probiotic Escherichia coli Nissle 1917 for treating diarrhea of greater than 4 days duration in infants and toddlers. Pediatr Infect Dis J. 2008 May 8.
186. Wickens K, Black PN, Stanley TV, et al. A differential effect of 2 probiotics in the prevention of eczema and atopy: A double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol. 2008 Aug 31.
187. Williams E, Stimpson J, Wang D, et al. Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study. Aliment Pharmacol Ther. 2008 Sep 10.
188. Agrawal A, Houghton LA, Morris J, et al. Clinical trial: the effects of a fermented milk product containing Bifidobacterium lactis DN-173-010 on abdominal distension and gastrointestinal transit in irritable bowel syndrome with constipation. Aliment Pharmacol Ther. 2008 Sep 17.
189. Lin HC, Hsu CH, Chen HL, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight preterm infants: a multicenter, randomized, controlled trial. Pediatrics. 2008;122:693-700.
193. Kuitunen M, Kukkonen K, Juntunen-Backman K, et al. Probiotics prevent IgE-associated allergy until age 5 years in cesarean-delivered children but not in the total cohort. J Allergy Clin Immunol. 2009;123:335-341.
194. Gibson RA, Barclay D, Marshall H, Moulin J, Maire JC, Makrides M. Safety of supplementing infant formula with long-chain polyunsaturated fatty acids and Bifidobacterium lactis in term infants: a randomised controlled trial. Br J Nutr . 2009; 101:1706-13.
195. Martinez RC, Franceschini SA, Patta MC, et al. Improved cure of bacterial vaginosis with single dose of tinidazole (2 g), Lactobacillus rhamnosus GR-1, and Lactobacillus reuteri RC-14: a randomized, double-blind, placebo-controlled trial. Can J Microbiol. 2009; 55:133-8.
196. Soh SE, Aw M, Gerez I, et al. Probiotic supplementation in the first 6 months of life in at risk Asian infants—effects on eczema and atopic sensitization at the age of 1 year. Clin Exp Allergy. 2009;39:571-8.
197. Silk DB, Davis A, Vulevic J, Tzortzis G, Gibson GR. Clinical trial: the effects of a trans-galactooligosaccharide prebiotic on faecal microbiota and symptoms in irritable bowel syndrome. Aliment Pharmacol Ther. 2009;29:508-18.
199. Underwood MA, Salzman NH, Bennett SH, et al. A randomized placebo-controlled comparison of 2 prebiotic/probiotic combinations in preterm infants: impact on weight gain, intestinal microbiota, and fecal short-chain fatty acids. J Pediatr Gastroenterol Nutr. 2009;48:216-25.
200. Enck P, Zimmermann K, Menke G, Klosterhalfen S. Randomized controlled treatment trial of irritable bowel syndrome with a probiotic E.-coli preparation (DSM17252) compared to placebo. Z Gastroenterol. 2009;47:209-14.
201. Mukerji SS, Pynnonen MA, Kim HM, Singer A, Tabor M, Terrell JE. Probiotics as adjunctive treatment for chronic rhinosinusitis: a randomized controlled trial. Otolaryngol Head Neck Surg. 2009;140:202-8.
202. Martinez RC, Franceschini SA, Patta MC, et al. Improved treatment of vulvovaginal candidiasis with fluconazole plus probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. Lett Appl Microbiol. 2009;48:269-74.
205. Kim JY, Kwon JH, Ahn SH, et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatr Allergy Immunol. 2010 Mar;21(2 Pt 2):e386.
207. Hickson M, D'Souza AL, Muthu N, Rogers TR, Want S, Rajkumar C, Bulpitt CJ. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ. 2007;335(7610):80.
208. Gao XW, Mubasher M, Fang CY, Reifer C, Miller LE. Dose-response efficacy of a proprietary probiotic formula of Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R for antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea prophylaxis in adult patients. Am J Gastroenterol. 2010;105(7):1636-1641.
209. Ya W, Reifer C, Miller LE. Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study. Am J Obstet Gynecol. 2010;203(2):120.e1-6.
213. Romeo MG, Romeo DM, Trovato L, Oliveri S, Palermo F, Cota F, Betta P. Role of probiotics in the prevention of the enteric colonization by Candida in preterm newborns: incidence of late-onset sepsis and neurological outcome. J Perinatol. 2011;31(1):63-69.
214. Guandalini S, Magazzù G, Chiaro A, et al. VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study. J Pediatr Gastroenterol Nutr. 2010;51(1):24-30.
215. Cimperman L, Bayless G, Best K, et al. A randomized, double-blind, placebo-controlled pilot study of Lactobacillus reuteri ATCC 55730 for the prevention of antibiotic-associated diarrhea in hospitalized adults. J Clin Gastroenterol . 2011 May 5.
216. Choi CH, Jo SY, Park HJ, Chang SK, Byeon JS, Myung SJ. A randomized, double-blind, placebo-controlled multicenter trial of saccharomyces boulardii in irritable bowel syndrome: effect on quality of life. J Clin Gastroenterol. 2011;45(8):679-683.
221. Maldonado J, Cañabate F, Sempere L, et al. Human milk probiotic Lactobacillus fermentum CECT5716 reduces the incidence of gastrointestinal and upper respiratory tract infections in infants. J Pediatr Gastroenterol Nutr. 2012;54(1):55-61.
223. Horvath A, Dziechciarz P, Szajewska H. Meta-analysis: Lactobacillus rhamnosus GG for abdominal pain-related functional gastrointestinal disorders in childhood. Aliment Pharmacol Ther. 2011;33(12):1302-1310.
224. Guglielmetti S, Mora D, Gschwender M, Popp K. Randomised clinical trial: Bifidobacterium bifidum MIMBb75 significantly alleviates irritable bowel syndrome and improves quality of life--a double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2011;33(10):1123-1132.
226. Beerepoot MA, Ter Riet G, Nys S, et al. Lactobacilli vs antibiotics to prevent urinary tract infections: a randomized, double-blind, noninferiority trial in postmenopausal women. Arch Intern Med. 2012;172(9):704-712.
230. Francavilla R, Lionetti E, et al. Randomised clinical trial: Lactobacillus reuteri DSM 17938 vs. placebo in children with acute diarrhoea--a double-blind study. Aliment Pharmacol Therap . 2012;36(4):363-369.
231. Szajewska H, Gyrczuk E, et al. Lactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: a randomized, double-blind, placebo-controlled trial. J Pediatr. 2013;162(2):257-262.
233. Savino R, Pelle E, et al. Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics. 2007;119(1):124-130.
236. Chatterjee S, Kar P, et al. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated diarrhoea. J Assoc Physicians India. 2013;61(10):708-712.
238. Ford AC, Quigley EM, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: Systematic review and meta-analysis. Am J Gastroenterol. 2014;109(10):1547-1561.
242. Cuello-Garcia., Brozek JL, Fiocchi A, et al. Probiotics for the prevention of allergy: a systematic review and meta-analysis of randomized controlled trials. J Allergy Clin Immunol. 2015;136(4):952-961.
Last reviewed December 2015 by EBSCO CAM Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2012 EBSCO Publishing All rights reserved.
What can we help you find?close ×