Probiotics are preparations that contain viable, microbial agents that have been demonstrated to improve health. Most commonly, probiotics are freeze-dried. Live bacteria and yeasts are also available.

Genus - Species - Strain

e.g. Lactobacillus - rhamnosus - GG

Probiotic evidence is characterised by strain, as outlined in this clinical guide. The strain of the probiotic is of upmost importance to prescribers as it will indicate which conditions is has demonstrated effectiveness against.

Clinical Gem:

Never use probiotics that do not list the strain on the packaging.

Administered probiotics do not become permanent residents in the gastrointestinal tract. The do possess a wide variety of therapeutic effects, dependant on strain.

Probiotics are standardised in terms of the amount of living bacteria per dose. Each living bacterium is referred to as a colony forming unit (CFU).

The dosage of probiotics and supplements is based on the number of live organisms. Successful clinical trials use between 107–1011 CFU/day.

Clinical Gem:

Probiotics are best consumed with or after meal for maximum survivability of the bacteria.

Probiotics come in various preparations. Yoghurts, liquids and capsules. The key is that as long as the correct strain is found in the preparation at a high enough dose, it will be effective regardless of the type of preparation.

Probiotics are generally well tolerated in clinical trials. The incidence of adverse events is rare with the most common being gastrointesintal in nature (bloating, flatulence). Exercise caution when prescribing of probiotics to immunosuppressed or severely ill patients.