Probiotics
in Clinical Use
(Dr. Guru Prasad Mohanta,
Professor, Department of Pharmacy, Annamalai University, Annamalai Nagar – 608
002, Tamil Nadu, E. mail: gpmohanta@hotmail.com)
The
probiotics have been known to be beneficial for our health. A recent study
report from USA claims that eating probiotics-rich yogurt twice a day for a
month can relieve anxiety and stress by reducing activity in the emotional
region of the brain. Lets us look at their real status. The probiotics are
live, non-pathogenic microorganisms. In USA they are available as dietary
supplements and are not approved for any indication. These live microbes
usually are bacteria and yeast.
How do they help?
Acetic
acid, lactic acid and propionic acid produced by Lactobacillus lower intestinal pH and inhibit the growth of
pathogenic bacteria like Escherichia coli
and Clostridium spp. The presence of probiotics in the
intestinal tract physically and chemically prevents adhesion and colonization
of pathogenic bacteria. They may induce
or enhance the immune response. These live cultures restore or maintain a
healthy microbial flora.
Issues in their Use:
The
probiotics are not free from adverse effects. They can cause gas, diarrhoea,
bloating and hiccups. But they are mild. Infectious complications have also
been reported with certain probiotics. Sepsis with Lactobacillus casei, fungemia with S. boulardi and liver abscess due to Lactobacillus GG were reported in highly immunosuppressed and
critically ill patients. Antibacterials can inactivate bacteria derived
probiotics. Systemic antifungal like fluconazole may inactivate S. boulardii. Some of the studies reported that some preparations
have been found to contain smaller quantities or different species of organisms
to those specified in label.
Sources of probiotics:
The
curd used by all of us every day is a natural probiotic. But it does not have
all types of species. Now the probiotic fortified curd is also available in the
market. Probiotics are available as powders, capsules and tablets in medical
stores.
Conclusion:
The
evidence showed that probiotics such as Lactobacillus
spp. and Saccharomyces boulardii
are helpful in Clostridium difficile
infection and antibiotic associated diarrhoea. Though they are believed to be
harmless, it is not so. They may cause serious infections in some highly
immunosuppressed or critically ill patients. While advising or prescribing
probiotics care should be taken: to avoid giving together with antibiotics. The
antibiotics kill them. It is necessary wait for the antibiotics course to be
over before starting probiotics. The patients are to be advised:
·
Check the expiry date before buying.
·
Do not freeze acidophilus. Keep the product in a cool, dry
place. The refrigerator is preferable.
·
Do not drink chlorinated water as chlorine kills bacteria.
·
Follow the instruction given on the label of the product.
