1. Use of Probiotics in Larger Controlled Trials in Humans
Prevention of Diarrhea
antibiotic associated diarrhea
infantile diarrhea
traveler’s diarrhea
Treatment of Diarrhea
Clostridium difficile disease
acute diarrhea - pediatric and adult

2. D’Souza et al., BMJ 2002;324:1361

3. Saccharomyces boulardii and Antibiotic Associated Diarrhea in Hospitalized Patients N=180; site: University of Washington, Harborview Hospital
Start Antibiotic
Stop Antibiotic
Stop Study
Yeast continued for 14d
Start Yeast (within 48h)

4. Surawicz et al., Gastroenterol. 1989;96:981

5. Huang, et al. , Digestive Diseases and Sciences, Vol. 47, No
Huang, et al., Digestive Diseases and Sciences, Vol.47, No. 11 (Nov 2002)

9. McFarland et al., JAMA; 271, 1913-1918, (1994).

10. S. boulardii & High Dose Vancomycin for C. difficile Disease [Results]
50%
*p=0.05
16.7%*
Placebo (n=14)
S. boulardii (n=18)
Surawicz CM. Clin Infect Dis 2000;31:

11. Other Uses for Probiotics –Limited Data
Crohn’s Disease
Ulcerative Colitis
Pouchitis
Allergy/Exema
Irritable Bowel Syndrome Dental caries
High Cholesterol Urinary Tract Infections
Helicobacter pylori
Lactose Intolerance
Candida vaginal infections
Bacterial Vaginosis

12. From Elmer GW, Am J. Health-Sys Pharmacy 2001;58:1101-1107
Lactobacillus plantum for IBS looks promising

13. Probiotics Summary
Living microorganisms with multiple mechanisms of action
Good safety profile
Some applications to prevent and treat infectious diseases
An alternative to antimicrobials in some situations
May have other applications, e.g. allergy, colitis
Product selection is important