Keep misconceptions in mind when recommending probiotics

Consider common misconceptions about probiotics when recommending them to patients.
Consider common misconceptions about probiotics when recommending them to patients.

SAN ANTONIO – Recognizing common misconceptions about probiotics can help nurse practitioners (NPs) determine the most appropriate probiotics for their patients, according to research presented at the American Association of Nurse Practitioners (AANP) 2016 National Conference.

Researchers addressed 2 common misconceptions about probiotics. The first misconception was “All probiotics are the same.” They noted that different strains of probiotics have different health effects. The benefits can vary by genus, species/sub-species, and strain. The researchers used clinical evidence to provide recommended strains of probiotic for various clinical conditions, summarized in the following table:

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Clinical conditions Recommended strain(s) with clinical evidence

Antibiotic-associated diarrhea

Saccharomyces boulardi, Lactobacillus rhamnosus GG, Lactobacillus casei DN114 001, combined; or Lactobacillus acidophilus CL1285 plus Lactobacillus casei

Atopic dermatitis

Lactobacillus rhamnosus GG

Clostridium difficile-associated disease

Lactobacillus rhamnosus GG, Saccharomyces boulardi

Gut transit time

Bifidobacterium lactis DN-173 010

Inflammatory bowel disease (IBD): pouchitis

Lactobacillus acidophilus SD5212, Lactobacillus paracasei SD5218, Lactobacillus bulgaricus SD5210, Lactobacillus plantarum SD5209, Bifidobacterium infantis SD5220, Bifidobacterium longum SD5219, Bifidobacterium breve SD5206, Streptococcus thermophilus SD5207, combined

IBD: ulcerative colitis

Escherichia coli Nissle 1917; or Lactobacillus acidophilus SD5212, Lactobacillus paracasei SD5218, Lactobacillus bulgaricus SD5210, Lactobacillus plantarum SD5209, Bifidobacterium infantis SD5220, Bifidobacterium longum SD5219, Bifidobacterium breve SD5206, Streptococcus thermophilus SD5207, combined

Irritable bowel syndrome

Bifidobacterium longum 35624

Immune support

Lactobacillus rhamnosus GG, Bifidobacterium lactis HN019, Bifidobacterium lactis BB-12, Lactobacillus casei DN114001, Lactobacillus acidophilus LAFT1


The second misconception they addressed was “More probiotic is better.” Currently, the researchers noted, there is no conclusive evidence to show that probiotics with higher concentrations of bacteria or more species/strains improve their efficacy and health benefits. Different types of bacteria are effective at different amounts, they said, and the recommended amount and number of strains should be based on clinical studies that demonstrate a health benefit.

“Making clinical recommendations for probiotics is complicated by growing numbers of products and a paucity of validated data,” said the researchers. “However, [NPs] who keep these common misconceptions in mind will be better able to evaluate and recommend specific probiotics to their patients.”

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Reference

  1. Brenner DM, Messer CA, Sloan K. Facts and fiction: dispelling common misconceptions about probiotics. Presented at: the American Association of Nurse Practitioners (AANP) 2016 National Conference; June 21-26, 2016; San Antonio, TX.
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