Probiotics are bacterial cultures widely used in the treatment of disease. They are available without a prescription. Bacterial interference between types of bacteria and immunomodulation are the most common explanations as to why people may benefit from these treatments. The data on the use of probiotics in pediatric and adult diarrhea, inflammatory bowel disease, ileal pouchitis, urogenital infections, allergy, skin infections, and cancers are reviewed. Although generally safe, cases of complications from probiotic therapy are discussed, as well as potential problems that may develop.
This is a preview of subscription content, log in to check access.
Food and Agriculture Organization, World Health Organization. Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria: Report of Joint FAO/WHO Expert Consultation. Rome, Italy: Food and Agriculture Organization; 2001.
Metchnikoff E. The Prolongation of Life, New York, NY: Putnam & Sons; 1908.
Silva M, Jacobus NV, Deneke C, et al. Antimicrobial substance from a human lactobacillus strain. Antimicrob Agents Chmother 1987;31:1231–1233.
Michail S, Wei S, Mack DR. Escherichia coli strain E2348/69 in vitro adhesion is reduced in the presence of a Lactobacillus species. Gastroenterology 1997;112:A1042.
Kaila M, Isolauri E, Soppi E, et al. Enhancement of the circulating antibody secreting cell response in human diarrhea by a human lactobacillus strain. Pediatr Res 1992;32:141–144.
Miettinem M, Matikainen S, Vuopio-Varkila J, et al. Lactobacilli and streptococci induce interleukin-12 (IL-12), IL-18, and gamma interferon production in human peripheral blood monocellular cells. Infect Immun 1998;66:6058–6062.
Van Niel CW, Feudtner C, Garrison MM, Christakis DA. Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics 2002;109:678–684.
Huang JS, Bousvaros A, Lee JW, Diaz A, Davidson EJ. Efficacy of probiotic use in acute diarrhea in children: a meta-analysis. Dig Dis Sci 2002;47:2625–2634.
Costa-Ribeiro H, Ribeiro TC, Mattos AP, et al. Limitations of probiotic therapy in acute, severe dehydrating diarrhea. J Pediatr Gastroenterol Nutr 2003;36:112–115.
Arvola T, Laiho K, Torkkeli S, et al. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics 1999;104:e64.
Vanderhoof JA, Whitney DB, Antonson DL, et al. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr 1999;135:564–568.
McFarland LV, Surawicz CM, Greenberg RN. Prevention of beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol 1995;90:439–448.
Lewis SJ, Potts LF, Barry RE. J Infect 1998;36:171–174.
McFarland LV, Surawicz CM, Greenberg RN, et al. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA 1994;271:1913–1918.
Surawicz CM, McFarland LV, Greenberg RN, et al. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin Infect Dis 2000;31:1012–1017.
Attar A, Flourie B, Rambaud JC, et al. Antibiotic efficacy in small intestinal bacterial overgrowth-related chronic diarrhea: a crossover, randomized trial. Gastroenterology 1999;117:794–797.
Guslandi M, Mezzi G, Sorghi M, et al. Saccharomyces boulardii in maintenance treatment of Crohn’s disease. Dig Dis Sci 2000;45:1462–1464.
Kruis W, Schutz E, Fric P, et al. Aliment Pharmacol Ther 1997;11:853–858.
Rembacken BJ, Snelling AM, Hawkey PM, Chalmers DM, Axon AT. Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial. Lancet 1999;354:635–639.
Gionchetti P, Rizzello F, Ventri A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double blind, placebo-controlled trial. Gastroenterology 2000;119:305–309.
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.
Wendakoon CN, Thomson ABR, Ozimek L. Lack of therapeutic effect of a specially designed yogurt for the eradication of Helicobacter pylori infection. Digestion 2002;65:16–20.
Hilton E, Isenberg HD, Alperstein P, et al. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginaitis. Ann Intern Med 1992;116:353–357.
Hilton E, Rindos P, Esenberg HD. Lactobacillus GG vaginal suppositories and vaginitis. J Clin Microbiol 1995;33:1433.
Hillier S. The vainal microbial ecosystem and resistance to HIV. AIDS Res Hum Retroviruses 1998;14:S17-S21.
Klebanoff SJ, Coombs RW. Viricidal effect of Lactobacillus acidophilus on human immunodeficiency virus type I: possible role in heterosexual transmission. J Exp Med 1991;174:289–292.
Kalliomaki M, Salminen S, Arvilommi H, et al. Probiotic in primary prevention of atopic disease: a randomized placebo-controlled trial. Lancet 2001;357:1076–1079.
Nikitensko VI. Infection prophylaxis of gunshot wounds using probiotics. J Wound Care 2004;13:363–366.
Nikitenko VI, Zakharov VV, Borodin AV, et al. Role of bacterial translocation in pathogenesis of surgical infection. Khirurgiia 2001;2:63–66.
Roos K, Holm SE, Grahn E, et al. Alpha-streptotocci as supplementary treatment of recurrent streptococcal tonsillitis: a randomized plaebo-controlled study. Scand J Infect Dis 1993;25:31–35.
Roos K, Holm SE, Grahn, et al. Recolonization with four selecdted alpha-streptococcal strains in the treatment of recurrent streptococcal tonsillitis—a placebo-controlled randomized multicenter study. Scand J Infect Dis 1996;34:542–584.
Roos K, Grahn-Hakansson E, Holm S. Effect of recolonisation with “interfering” alpha-streptococci on recurrences of acute and secretory otitis media in children: randomized placebo controlled trial. BMJ 2001;322:210–212.
Gan BS, Kim J, Reid G, et al. Lactobacillus fermentum RC-14 inhibits Staphylococcus aureus infection of surgical implants in rats. J Infect Dis 2002;185:1369–1372.
Rayes N, Hansen S, Seehofer D, et al. Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery. Nutrition 2002;18:609–615.
Rayes N, Seehofer D, Hansen S, et al. Early enteral supply of lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients. Transplantation 2002;74:123–127.
Anderson AD, McNaught CE, Jain PK et al. Randomised clinical trial of symbiotic therapy in elective surgical patients. Gut 2004;53:241–245.
Lin-Amster H, Rochat F, Saudan KY, et al. Modulation of a specific humoral immune response and changes in intestinal flora mediated through fermented milk intake. FEMS Immunol Med Microbiol 1994;10:55–64.
Hirayama K, Rafter J. The role of probiotic bacteria in cancer prevention. Microbes Infect 2000;2:681–686.
Aso Y, Akazan H. Prophylactic effect of a Lactobacillus casei preparation on the recurrence of superficial bladder cancer. BLP Study Group. Urol Int 1992;49:125–129.
Aso Y, Akaza H, Kotake T, et al. Preventive effect of a Lactobacillus casei preparation on the recurrence of superficial bladder cancer in a double blind trial. The BLP Study Group. Eur Urol 1995;27:104–109.
Niault M, Thomas F, Prost J, et al. Fungemia due to Saccharomyces species in a patient treated with enteral Saccharomyces boulardii. Clin Infect Dis 1999;28:930.
Presterl E, Kneifl W, Mayer HK, et al. Endocarditis by Lactobacillus rhamnosus due to yoghurt ingestion? Scand J Infect Dis 2001;33:710–714.
Mackay AD, Taylor MB, Kibbler CC, et al. Lactobacillus endocarditis caused by a probiotic organism. Clin Microbiol Infect 1999;5:290–292.
Apostolou E, Kirjavainen P, Saxelin M, et al. Good adhesion properties of probiotics: a potential risk for bactermia? FEMS Immunol Med Microbiol 2001;31:35–39.
Rautio M, Jousimies-Somer H, Kauma H, et al. Liver abscess due to a Lactobacillus rhamnosus strain indistinguishable from Lactobacillus rhamnosus strain GG. Clin Infect Dis 1999;28:1159–1160.
See endnote 100 in Potential uses of probiotics in clinical practice.
Weese JS. Microbiologic evaluation of commercial probiotics. J Am Vet Med Assoc 2002;15:794–797.
The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors do discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.
About this article
Cite this article
Macintyre, A., Childscymet, T. Probiotics The benefits of bacterial cultures . Compr Ther 31, 181–185 (2005). https://doi.org/10.1385/COMP:31:3:181
- Bacterial Vaginosis
- Comp THER
- Probiotic Group
- Saccharomyces Boulardii