Recommendations for Probiotic Use-2011 Update

Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT 06150, USA.
Journal of clinical gastroenterology (Impact Factor: 3.5). 11/2011; 45 Suppl(3):S168-71. DOI: 10.1097/MCG.0b013e318230928b
Source: PubMed


This study describes the consensus opinion of the participants of the third Yale Workshop on probiotic use. There were 10 experts participating. The recommendations update those of the first 2 meetings that were published in 2005 and 2008. The workshop presentations and papers in this supplement relate to the involvement of normal microbiota involved in intestinal microecology, how the microbes interact with the intestine to affect our immunologic responses, the stability and natural history of probiotic organisms, and the role of the intestinal microbatome with regard to affecting cardiac risk factors and obesity. Recommendations for the use of probiotics in necrotizing enterocolitis, childhood diarrhea, inflammatory bowel disease, irritable bowel syndrome, and Clostridium difficile diarrhea are reviewed. As in previous publications, the recommendations are given as A, B, or C ratings. The recent positive experiences with bacteriotherapy (fecal microbiome transplant) are also discussed in detail and a positive recommendation is made for use in severe resistant C. difficile diarrhea.

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    • "In the studies by Floch et al. (2011) "
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    DESCRIPTION: Probiotics in Clostridium difficile infection: reviewing the need for a multistrain probiotic
    Full-text · Research · Sep 2015
    • "When applied in adequate amounts probiotics are beneficial to the host; they improve the colonic barrier function impaired by early-life stress and have been used to treat many illnesses such as diarrhoea, IBD, and other gut disorders (Floch et al., 2011). Administration of probiotics has been reported to modulate the gut microbiota (Lyra et al., 2010) and regulate the HPA axis activity in the neonatal maternal separation model (Gareau et al., 2007). "
    T Wang · X Hu · S Liang · W Li · X Wu · L Wang · F Jin
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    ABSTRACT: Gut microbiota play a vital role in maintaining the health of the host. Many factors affect gut microbiota; application of broad range antibiotics disturb microbiota, while probiotic application protects the microbiota. To investigate how probiotics alter the physiological and psychological changes induced by antibiotics, we tested the performance of ampicillin-treated rats in the presence or absence of Lactobacillus fermentum strain NS9, in elevated plus maze and Morris water maze. The results showed that NS9 normalised the composition of gut microbiota and alleviated the ampicillin-induced inflammation in the colon. The levels of the mineralocorticoid and N-methyl-D-aspartate receptors were also elevated in the hippocampus of the ampillicin+NS9 treated group. NS9 administration also reduced the anxiety-like behaviour and alleviated the ampicillin-induced impairment in memory retention. These findings suggest that NS9 is beneficial to the host, because it restores the physiological and psychological abnormalities induced by ampicillin. Our results highlight how gut contents regulate the brain, and shed light on the clinical applications of probiotics to treat the side effect of antibiotics and mental disorders.
    No preview · Article · Apr 2015 · Beneficial Microbes
    • "Water and electrolyte replacement does not substantially shorten the frequency/duration of diarrhoea and has not been found to reduce stool volume, prompting a growing interest in adjunctive treatments (Vandenplas et al., 2007). Probiotics have been proposed as a complementary therapy in the treatment of acute diarrhoea (Floch et al., 2011;Guarino et al., 2014;Guarner et al., 2012;Szajewska et al., 2014). The most widely evaluated outcomes are the duration and severity of diarrhoea, and the duration of hospitalisation. "
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    ABSTRACT: Evidence from the literature has shown that Saccharomyces boulardii provides a clinically significant benefit in the treatment of acute infectious diarrhoea in children. In this multicentre, randomised, prospective, controlled, single blind clinical trial performed in children with acute watery diarrhoea, we aimed to evaluate the impact of S. boulardii CNCM I-745 in hospitalised children, in children requiring emergency care unit (ECU) stay and in outpatient settings. The primary endpoint was the duration of diarrhoea (in hours). Secondary outcome measures were duration of hospitalisation and diarrhoea at the 3rd day of intervention. In the whole study group (363 children), the duration of diarrhoea was approximately 24 h shorter in the S. boulardii group (75.4±33.1 vs 99.8±32.5 h, P<0.001). The effect of S. boulardii (diarrhoea-free children) was observed starting at 48 h. After 72 h, only 27.3% of the children receiving probiotic still had watery diarrhoea, in contrast to 48.5% in the control group (P<0.001). The duration of diarrhoea was significantly reduced in the probiotic group in hospital, ECU and outpatient settings (P<0.001, P<0.01 and P<0.001, respectively). The percentage of diarrhoea-free children was significantly larger after 48 and 72 h in all settings. The mean length of hospital stay was shorter with more than 36 h difference in the S. boulardii group (4.60±1.72 vs 6.12±1.71 days, P<0.001). The mean length of ECU stay was shorter with more than 19 h difference in the probiotic group (1.20±0.4 vs 2.0±0.3 days, P<0.001). No adverse effects related to the probiotic were noted. Because treatment can shorten the duration of diarrhoea and reduce the length of ECU and hospital stay, there is likely a social and economic benefit of S. boulardii CNCM I-745 in adjunction to oral rehydration solution in acute infectious gastroenteritis in children.
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