Number one recommended probiotic
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Number One Recommended Probiotic: A Comprehensive Review
Introduction to Probiotics
Probiotics are live microorganisms that, when administered in adequate amounts, confer health benefits to the host. They are widely used for various gastrointestinal conditions, including antibiotic-associated diarrhea (AAD) and acute gastroenteritis (AGE). However, the efficacy of probiotics is highly strain-specific and disease-specific, making the choice of the right probiotic crucial for effective treatment and prevention.
Probiotics for Antibiotic-Associated Diarrhea (AAD)
Lactobacillus rhamnosus GG and Saccharomyces boulardii
For the prevention of antibiotic-associated diarrhea in children, the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) recommends the use of Lactobacillus rhamnosus GG and Saccharomyces boulardii. These recommendations are based on a systematic review of randomized controlled trials (RCTs) and are supported by moderate quality of evidence (QoE) with strong recommendations1. Both strains have shown efficacy in reducing the incidence of AAD, particularly in children with risk factors such as prolonged antibiotic use, hospitalization, and previous episodes of AAD1.
Probiotics for Acute Gastroenteritis (AGE)
Lactobacillus rhamnosus GG and Saccharomyces boulardii
In the management of acute gastroenteritis in children, Lactobacillus rhamnosus GG and Saccharomyces boulardii are also recommended. Despite the low quality of evidence, these probiotics have received strong recommendations due to their consistent performance in multiple RCTs2. They are suggested as adjuncts to rehydration therapy to help reduce the duration and severity of diarrhea in children2.
Evidence-Based Selection of Probiotics
Strain-Specific Efficacy
The selection of an appropriate probiotic is complex and should be based on the specific strain's efficacy for the targeted condition. A comprehensive review of 249 trials identified Saccharomyces boulardii I-745 and a three-strain mixture (Lactobacillus acidophilus CL1285, L. casei Lbc80r, L. rhamnosus CLR2) as having strong evidence for the prevention of AAD3. Additionally, Lactobacillus casei DN114001 has also shown strong efficacy in preventing AAD3.
Practical Considerations
When choosing a probiotic, it is essential to consider factors such as the specific strain, the targeted disease, the formulation, the dose, and the product's quality control and shelf-life. The efficacy of probiotics is not universal; it varies significantly depending on these factors3.
Conclusion
In summary, Lactobacillus rhamnosus GG and Saccharomyces boulardii are the most recommended probiotics for preventing antibiotic-associated diarrhea and managing acute gastroenteritis in children. Their efficacy is supported by multiple RCTs and systematic reviews, making them reliable choices for these conditions. However, the selection of a probiotic should always be tailored to the specific needs of the patient, considering the strain-specific and disease-specific efficacy.
Sources and full results
Most relevant research papers on this topic
Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children.
Probiotics, particularly Lactobacillus rhamnosus GG and Saccharomyces boulardii, can help prevent antibiotic-associated diarrhea in children.
Systematic Review
Highly CitedUse of probiotics for management of acute gastroenteritis: a position paper by the ESPGHAN Working Group for Probiotics and Prebiotics.
Probiotics Lactobacillus rhamnosus GG and Saccharomyces boulardii show strong recommendations for treating acute gastroenteritis in children, with less compelling evidence for Lactobacillus reuteri DSM 17938 and heat-inactivated Lactobacillus acid
Systematic Review
Very Rigorous JournalHighly CitedChoosing an appropriate probiotic product for your patient: An evidence-based practical guide
The choice of an appropriate probiotic depends on the mode and type of disease, specific efficacy of probiotic strain(s), product quality, and formulation.
Literature Review
Rigorous JournalHighly CitedMicroorganisms with Claimed Probiotic Properties: An Overview of Recent Literature
Probiotics, especially those from Lactobacillus and Bifidobacterium genera, show health benefits for healthy individuals, but caution is needed for immunocompromised patients and those with leaky guts.
Literature ReviewHighly CitedProbiotics and Preterm Infants: A Position Paper by the ESPGHAN Committee on Nutrition and the ESPGHAN Working Group for Probiotics and Prebiotics.
Probiotics may reduce necrotising enterocolitis rates in preterm infants, but specific strains and dosages need to be determined, with safety issues being crucial.
Highly CitedProbiotics as potential antioxidants: a systematic review.
Probiotics exhibit antioxidant potential, potentially reducing oxidative damage and free radical scavenging in human cells.
Systematic ReviewHighly CitedProbiotics for the Management of Pediatric Gastrointestinal Disorders: Position Paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications
Probiotics show potential in managing pediatric gastrointestinal disorders, but further studies are needed to confirm their effectiveness and avoid using probiotics without documented health benefits.
World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Probiotics
Probiotic supplementation may prevent eczema in high-risk individuals, but its effectiveness in preventing allergy in children remains unclear.
Systematic ReviewHighly CitedProbiotics for the Prevention of Nosocomial Diarrhea in Children
Lactobacillus rhamnosus GG is recommended as a probiotic for preventing nosocomial diarrhea in children, based on current evidence.
Systematic ReviewRecommendation and limitation of probiotics supplements
Probiotic supplements are recommended for various gastrointestinal health issues, but more research is needed to understand their side effects, precautions, and warnings for adults and children.
Literature Review