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Probiotic Probioticsarelivemicroorganisms(bacteria
oryeasts)which,whenadministeredinadequateamounts,
conferahealthbenefitonthehost
Prebiotic - nutritional supplement taken to increase the
amounts of beneficial bacterial in the gut or vagina.
Example FOS (fructose oligosaccharides)
Biotherapeutic agent - microorganism used for specific
therapeutic activity in humans
Nutriceutical - food products with beneficial effects in
preventing or treating diseases
Kidneys: sterile
Bladder: sterile
Urethra: 101-102 E. coli
yeast or placebo
continued for 3d
Start yeast
or placebo
McFarland et
al. Am J
Gastroenterol
1995;90:439448
35
30
*p<0.05
25
16.7
20
15
10
5
6.7*
2.2*
Placebo
(n=36)
Szajewska H. J Pediatr 2001;138:361-5.
L. GG (n=45)
ND
Rotaviral
treated
control
dur (h)
d5 dia (%)
d5 rota(%)
hosp days
Huang,etal.,DigestiveDiseasesandSciences,Vol.47,No.11(Nov2002)
McFarlan
detal.,
JAMA;
271,
1913
1918,
(1994).
% CDD recurrences
50
50%
*p=0.05
40
30
16.7%
*
20
10
0
Placebo
(n=14)
Surawicz CM. Clin Infect Dis 2000;31:1012-7.
S. boulardii
(n=18)
Rates of Clostridium difficile per 100 000 Patients in the United Kingdom General Practice
Research Database
severity
Risk
Dental caries
High Cholesterol
Helicobacter pylori
Lactose Intolerance
Candida vaginal infections
Bacterial Vaginosis
Disadvantages
Multiple Mechanisms of
Action
Resistance is Infrequent
Use May Reduce
Exposure to Antibiotics
Delivery of Microbial
Enzymes
Well Tolerated
Benefit to Risk Ration is
Favorable
Persistence Possible
Translocation Possible
Transfer of Resistance
Plasmids?
Infection Possible
Quality Control Issues
Regulatory Issues in USA
Lactobacillus rhamnosus GG
Dietary Supplement: Culturelle
L. acidophilus L. reueri
LGG
Sb
AAD
Uneven
Good
Good
Good
Acute
Adult
Good
Good
Acute
?
pediatric
Good
Good
Traveler ?
diarrhea
Fair
Fair
C. dif
Limited
Good
BV
Good** Good*** ?
Probiotics Summary
Living microorganisms with multiple mechanisms
of action
Good safety profile
Some applications to prevent and treat infectious
diseases
An alternative to antibiotics in some situations
May have other applications, e.g. allergy, cancer,
colitis, IBS
Product selection is very important