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Page 37
Journal of Public Health and Nutrition | Volume 2
July 05-06, 2019 | Paris, France
International Conference and Exhibition on
17th World Congress on
Probiotics, Nutrition and Functional Foods
Pediatrics and Nutrition
Joint Event
&
Choosing the appropriate probiotic for your patient based on strain and disease
specificity
Lynne V McFarland
University of Washington, USA
Probiotics are living microbes, when used in adequate
amounts, have a beneficial effect on the health of humans. As
the popularity of different types of probiotics have become
available, it has become increasingly difficult to know which
types should be used for specific diseases.
Methods: A systematic review using standard databases
(PubMed, Google Scholar) from 1977-December 2018
was conducted for randomized controlled trials (RCTs) of
probiotics. Meta-analyses were done to determine if efficacy
was strain-specific and/or disease-specific. A graded review
was done to determine which probiotic strains had strong
evidence for 19 different diseases.
Results: Results of the meta-analyses showed clear evidence
that probiotics are both strain and disease specific, hence
efficacy needs to be evaluated based on separate probiotic
type and disease sub-groups. Of 816 RCTs screened, only
249 had at least 2 RCTs/probiotic type for specific diseases
(prevention of 11 different diseases or treatment of 8
different diseases). Of the 22 different types of single-strain
or multi-strain mixtures, 15 (68%) had strong evidence of
efficacy. For example, of the 61 RCTs for the prevention of
antibiotic-associated diarrhea, only four types of probiotics
had strong-moderate evidence for efficacy (S. boulardii
I-745, L. casei DN114001, E. faecalis SF-38 and a three-strain
mixture (Bio-K+), while 4 other probiotic types had non-
significant findings of efficacy. For the treatment of eight
different diseases, the treatment of acute pediatric diarrhea
had the most RCTs (n=61) and 7 different types of probiotics
had strong evidence of efficacy, while one mixture had only
moderate evidence. There was no ‘universal’ probiotic that
was effective for every disease.
Conclusion: This analysis clearly demonstrated that not all
probiotics are equally effective and the choice should be
based on the evidence for the specific strain or strains for
each specific disease.
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