Evidence-based adult indications for probiotics, prebiotics, and synbiotics in gastroenterology
| Clinical Condition | Probiotic strain | Recommended dose | References |
|---|---|---|---|
| acute diarrhea in adults | – Lactobacillus paracasei B 21060 | 109 CFU twice daily | [16, 66] |
| – Lactobacillus rhamnosus GG | 109 CFU twice daily | ||
| – Saccharomyces cerevisiae var. boulardii CNCM I-745 | 5x 109 CFU/capsule | ||
| acute gastroenteritis in children | – L. rhamnosus GG | ≥ 1010 CFU/day | [16, 22, 66] |
| – S. boulardii CNCM I745 | 250–750 mg/day | ||
| – Lactobacillus reuteri DSM 17938 | 108 to 4 × 108 CFU | ||
| antibiotic-associated diarrhea | – L. rhamnosus GG | 1010 CFU/capsule twice daily | [28, 66, 68, 69, 71] |
| – S. boulardii CNCM I-745 | 5 × 109 CFU/capsule | ||
| – L. reuteri DSM 17938 | 1 × 108 CFU twice daily | ||
| – Yogurt with Lactobacillus casei DN114, Lactobacillus bulgaricus, and Streptococcus thermophilus | ≥ 1010 CFU daily | ||
| –Lactobacillus acidophilus and L. bulgaricus or Bifidobacterium longum | |||
| Clostridium difficile-associated diarrhea | – L. acidophilus CL1285 and L. casei LBC80R | 5 × 1010 CFU daily and 4–10 × 1010 CFU daily | [58, 66, 68] |
| – S. boulardii | |||
| 5 × 109 CFU/capsule | |||
| Helicobacter pylori infection | – S. boulardii | 5 × 109 CFU/capsule | [66, 68, 70] |
| – L. rhamnosus GG | 6 × 109 twice daily | ||
| – L. casei DN-114 001 (in children) | |||
| Irritable Bowel Syndrome | – Bifidobacterium infantis 35624 | 1 × 108 CFU/capsule | [16, 32, 66, 68, 81] |
| – Bifidobacterium animalis DN-173 010 | 1010 CFU, twice daily | ||
| – L. plantarum DSM 9843 (299v) | 10 billion CFU once daily | ||
| – VSL#3* | |||
| ulcerative colitis (mild to moderate CU for the induction of remission) | – Escherichia coli Nissle 1917 | 5 × 1010 viable bacteria twice daily | [6, 47, 66, 72] |
| – VSL#3 | |||
| infantile colic | – L. reuteri DSM 17938 | 108 CFU, once daily | [66, 68, 73] |
| – L. rhamnosus GG | 1010–1011 CFU, twice daily | ||
| hepatic encephalopathy | – VSL#3 | 108 CFU three times daily | [16, 66] |
| traveler's diarrhea | – S. boulardii CNCM I-745 | 250–1000 mg, once daily | [12] |