Recommended amount of probiotics
Pro Research Analysisby 
Searched over 200M research papers
Recommended Amount of Probiotics: A Comprehensive Overview
Introduction to Probiotics and Their Benefits
Probiotics are live microorganisms that, when administered in adequate amounts, confer health benefits to the host. They are widely used for various health conditions, particularly gastrointestinal disorders, but the optimal dosage remains a topic of ongoing research and debate1 4.
Probiotic Dosage for Gastrointestinal Disorders
Acute Gastroenteritis and Antibiotic-Associated Diarrhea
The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommends specific probiotic strains for managing acute gastroenteritis and preventing antibiotic-associated diarrhea in children. For instance, Lactobacillus rhamnosus GG and Saccharomyces boulardii are strongly recommended, albeit with low-quality evidence1 5. The dosage for these strains typically ranges from 10^9 to 10^11 colony-forming units (CFU) per day, depending on the specific strain and condition being treated1 5.
Clostridium difficile Infection
In hospitalized adults, timely administration of probiotics has been shown to significantly reduce the incidence of Clostridium difficile infection (CDI). Probiotics are most effective when given within two days of starting antibiotics, with a recommended dosage often exceeding 10^10 CFU per day7. This early administration can reduce the risk of CDI by more than 50%7.
Dose-Response Relationships in Probiotic Efficacy
General Findings
Research indicates that the effectiveness of probiotics can vary significantly based on the dose. For example, higher doses (greater than 10^11 CFU) have been found to be more effective in reducing blood pressure compared to lower doses2. However, for other conditions like necrotizing enterocolitis and irritable bowel syndrome, no clear dose-response relationship has been established2.
Specific Strains and Conditions
Studies have shown a positive dose-response relationship for the prevention of antibiotic-associated diarrhea, with higher doses leading to better outcomes2. In simulated gastrointestinal passage studies, higher doses of probiotics resulted in greater recovery rates and increased production of beneficial metabolites like short-chain fatty acids3.
Combined Use of Probiotics and Prebiotics
For preterm infants, the combined use of probiotics and prebiotics has been shown to be more effective than probiotics alone. Specifically, combinations of Bifidobacterium and Lactobacillus with prebiotics have demonstrated significant reductions in mortality and morbidity from necrotizing enterocolitis6. The recommended dosages in these studies often exceed 10^9 CFU per day6.
Safety and Considerations
While probiotics are generally considered safe for healthy individuals, caution is advised for immunocompromised patients or those with a leaky gut, as there have been instances of infections and sepsis associated with probiotic use4. Therefore, the risk-benefit ratio should be carefully considered before prescribing probiotics to vulnerable populations4.
Conclusion
The recommended amount of probiotics varies depending on the specific strain and health condition. For most gastrointestinal disorders, doses ranging from 10^9 to 10^11 CFU per day are commonly used. However, the optimal dosage for many conditions remains to be conclusively determined, necessitating further research. Combining probiotics with prebiotics appears to enhance efficacy, particularly in preterm infants. As always, the safety and specific health benefits of probiotics should be established through rigorous clinical studies.
Sources and full results
Most relevant research papers on this topic
Probiotics 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.
A review of dose-responses of probiotics in human studies.
Higher doses of probiotics show a positive dose-response relationship for reducing antibiotic-associated diarrhoea risk, while other end-points show no clear dose-response relationship.
Highly CitedDose-Response Recovery of Probiotic Strains in Simulated Gastro-Intestinal Passage
Higher doses of probiotic strains are needed to achieve measurable increases in metabolic output and short chain fatty acids compared to placebo.
RCT
Rigorous JournalMicroorganisms 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 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 CitedEffects of Probiotics in Preterm Infants: A Network Meta-analysis
Combined use of prebiotic and probiotic, especially Lactobacillus or Bifidobacterium, is recommended for optimal premature infant health.
Meta-AnalysisTimely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis.
Probiotics given within 2 days of antibiotic initiation significantly reduce the risk of Clostridium difficile infection by over 50% in hospitalized adults.
Meta-AnalysisHighly CitedProbiotics (Direct-Fed Microbials) in Poultry Nutrition and Their Effects on Nutrient Utilization, Growth and Laying Performance, and Gut Health: A Systematic Review
Probiotics can enhance poultry growth and gut health, offering a potential alternative to antibiotic growth promoters in production.
Systematic ReviewRigorous JournalHighly CitedProbiotic yeast enhances growth performance of Nile tilapia (Oreochromis niloticus) through morphological modifications of intestine
Probiotic yeast supplementation significantly enhances growth performance and feed utilization in Nile tilapia, improving sustainability in aquaculture.
RCTProbiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.
Probiotics show potential in preventing Clostridium difficile-associated diarrhea in adults and children, but more research is needed to confirm their effectiveness and safety.
Meta-AnalysisVery Rigorous JournalHighly Cited