Probiotics in Clinical Use

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.