PDF of Ask A Pharmacist 0612

What are the benefits of probiotics? Does any particular kind offer more benefits than the others? —Herman Kurzweil

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The digestive tract hosts a variety of microorganisms necessary for health and proper digestion. The balance of microorganisms can be altered by administering antibiotics, increasing dietary intake of substances that promote the growth of beneficial bacteria (ie, prebiotics), or by administering the beneficial bacteria themselves (ie, probiotics). This is most frequently done in the course of treatment of gastrointestinal diseases such as inflammatory bowel disease or after experiencing diarrhea.

A variety of probiotics are available. These are most commonly derived from cultured milk products and may include Lactobacillus sp., nonpathogenic strains of Escherichia coli, Saccharomyces boulardii (a strain of yeast), and others. Administration of probiotics is believed to suppress the growth and proliferation of pathogenic bacteria, improve GI function, and potentially modulate the immune system. Although generally considered safe, there are few trials demonstrating effectiveness of these products in comparison to placebo or to one another. Patients who wish to take these products should be aware that most are derived from dairy; therefore, patients who are lactose intolerant should select a product that contains minimal lactose. Patients who are critically ill, neutropenic, or otherwise immunosuppressed should be counseled that these products have been associated with infections in certain patient populations. For these populations, use of probiotics should be delayed until their immune function is restored. ONA

Lisa Thompson is assistant professor, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado.