Probiotics are microorganisms with potential health benefits. They may help prevent and treat antibiotic-associated diarrhea (AAD) and relieve symptoms of irritable bowel syndrome.
Dr. Benjamin Kligler, Vice Chair of the Albert Einstein College of Medicine in New York, believes that patients often know more about probiotics than their doctors. Antibiotics kill both bad and good bacteria. Probiotics are good bacteria that help maintain the natural balance in the gut and do not interfere with antibiotics.
The most widely studied strains include Lactobacillus species (including L. acidophilus, L. rhamnosus, L. bulgaricus, L. reuteri and L. casei among others), Bifidobacterium species and Saccharomyces boulardii.
Helicobacter pylori (H. pylori) are bacteria that infect and inflame the stomach lining. Doctors now believe they are the most common cause of stomach ulcers and may cause stomach cancers. In a probiotics study, 90 children and teens with H. pylori, aged 3 to 18, took daily doses of two antibiotics plus an ulcer drug and 250 mg of the probiotic S. boulardii twice per day or a placebo for seven to 10 days. After four to six weeks, 93 percent of those in the probiotic group had no H. pylori compared to 81 percent for placebo. The placebo group reported four times the number of side effects compared to probiotics.
“With the level of evidence that probiotics work and the large safety margins for them, we see no good reason not to prescribe probiotics when prescribing antibiotics.”
Typical dosages vary based on the product, but common dosages range from 5 to 10 billion colony-forming units (CFU) per day for children and from 10 to 20 billion CFU per day for adults.
American Family Physician; 2008, Vol. 78, No. 9, 1073-8.