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Review
. 2005 Nov;51(11):1487-93.

Probiotics. Some evidence of their effectiveness

Gregor Reid  1 , Jo-Anne Hammond
Affiliations
Review

Probiotics. Some evidence of their effectiveness

Gregor Reid et al. Can Fam Physician. 2005 Nov.

Abstract
in English, French

Objective: To define the term probiotics, to indicate how to identify products that have been proven beneficial, and to assess the quality of evidence regarding probiotics.

Quality of evidence: A few level I studies support the effectiveness of specific probiotics for certain diagnoses. For most so-called probiotics, however, weak or no evidence supports their effectiveness.

Main message: Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Level I evidence supports use of VSL#3 for maintaining remission of inflammatory colitis. Probiotics for treating vaginal infections, Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, have level I evidence of effectiveness, but are not available in Canada. Specific probiotics taken for certain indications improve health and have few side effects.

Conclusion: Limited but good evidence supports the role of certain probiotics in medical practice. Because consumer pressure will undoubtedly stimulate further interest in probiotics, family doctors need to be informed about them so they can advise their patients appropriately.

OBJECTIF: Définir le terme probiotique, indiquer comment identifier les produits dont les effets bénéfiques ont été démontrés et évaluer la qualité des preuves concernant ces agents.

QUALITÉ DES PREUVES: L’efficacité de probiotiques spécifiques dans certaines conditions est appuyée par quelques études de niveau I. La majorité des soi-disant probiotiques, toutefois, ont peu ou pas de preuves d’efficacité.

PRINCIPAL MESSAGE: Les probiotiques sont des micro-organismes vivants qui, en doses adéquates, sont bénéfiques pour la santé de l’hôte. L’utilisation de VSL#3 pour garder en rémission une colite inflammatoire repose sur des preuves de niveau I. L’efficacité des probiotiques Lactobacillus rhamnosus GR-1 et Lactobacillus reuteri RC-14 utilisés pour traiter les infections vaginales repose sur des preuves de niveau I, mais ces agents ne sont pas disponibles au Canada. Certains probiotiques spécifiques utilisés pour des indications particulières améliorent la santé et ont peu d’effets secondaires.

CONCLUSION: Il existe des preuves limitées mais de bonne qualité à l’effet que les probiotiques ont un rôle à jouer dans la pratique médicale. Les consommateurs voudront nécessairement en savoir davantage sur ces produits et le médecin de famille doit donc se renseigner pour mieux conseiller ses patients à leur sujet.

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Conflict of interest statement

Competing interests: Dr Reid owns strains Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri (formerly fermentum) B-54 and RC-14.

Figures

Figure 1
Figure 1. Mean number of breakthrough infections per year in women taking Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum B-54 compared with number of infections among those using various other treatments-
Mean number of urinary tract infections was reduced from 6 per year with preventive treatment to less than 2.5 per year. The data suggest that weekly vaginal probiotic use compares with daily antibiotic treatment or twice-daily vaginal washes.
See this image and copyright information in PMC

Comment in

  • Probiotics-mixed messages.
    Mack DR. Mack DR. Can Fam Physician. 2005 Nov;51(11):1455-7, 1462-4. Can Fam Physician. 2005. PMID: 16353824 Free PMC article. No abstract available.

References

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