Probiotics as a Treatment for Infectious Diseases
Probiotics frequently are described as "good bacteria" or as a replacement for native gut bacteria. However, the World Health Organization identifies probiotics as "live microorganisms that, when consumed in adequate amounts as part of food, confer a health benefit on the host." In the United States, probiotics are commonly found in foods—typically dairy products—and dietary supplements. Microorganisms marketed as probiotic agents include species of Lactobacillus and Bifidobacterium (gram-positive, lactic acid–producing bacteria often found in the intestinal tract), although some dietary supplements may contain strains of Enterococcus, Bacillus, Streptococcus, and Escherichia, which are less commonly found in the intestinal tract.
Currently, any product containing probiotics is considered a dietary supplement and is governed by the rules and regulations set forth by the Dietary Supplement Health and Education Act of 1994. This means that the manufacturer can provide only general health claims for the product; it cannot state that any of the ingredients in the product can cure, treat, or prevent a disease. The manufacturer is required by the FDA to follow good manufacturing practices, but it does not have to provide data on the safety or effectiveness of the ingredients in the supplement. This lack of standardization and general labeling is yet another hurdle that pharmacists must negotiate when fielding consumer questions about probiotics. Table 1 highlights the probiotic microorganisms found in selected dietary supplement products in the U.S.
Probiotics have been advertised for a variety of conditions, including acute diarrhea, allergies, respiratory infections, irritable bowel syndrome, and inflammatory bowel disease. In addition, potential clinical applications for probiotics currently being researched include colon and bladder cancer, diabetes, and graft-versus-host disease in transplant patients.
Unlike the situation for many vitamins and minerals, there is no recommended daily dosage for probiotics. The probiotic dosage listed on a dietary supplement product is typically based on a study that has reported a health effect for that type of bacterium. This dosage can vary between different strains of bacteria, as well as by health condition. Specific strains and dosages— if known—for antibiotic-associated diarrhea, vulvovaginal candidiasis, and the common cold are discussed later in this article. Probiotics are sensitive to environmental conditions such as heat, moisture, oxygen, and light. Consumers should take precautions when storing products containing probiotics and follow the instructions indicated on the product label.
Overview
Probiotics frequently are described as "good bacteria" or as a replacement for native gut bacteria. However, the World Health Organization identifies probiotics as "live microorganisms that, when consumed in adequate amounts as part of food, confer a health benefit on the host." In the United States, probiotics are commonly found in foods—typically dairy products—and dietary supplements. Microorganisms marketed as probiotic agents include species of Lactobacillus and Bifidobacterium (gram-positive, lactic acid–producing bacteria often found in the intestinal tract), although some dietary supplements may contain strains of Enterococcus, Bacillus, Streptococcus, and Escherichia, which are less commonly found in the intestinal tract.
Currently, any product containing probiotics is considered a dietary supplement and is governed by the rules and regulations set forth by the Dietary Supplement Health and Education Act of 1994. This means that the manufacturer can provide only general health claims for the product; it cannot state that any of the ingredients in the product can cure, treat, or prevent a disease. The manufacturer is required by the FDA to follow good manufacturing practices, but it does not have to provide data on the safety or effectiveness of the ingredients in the supplement. This lack of standardization and general labeling is yet another hurdle that pharmacists must negotiate when fielding consumer questions about probiotics. Table 1 highlights the probiotic microorganisms found in selected dietary supplement products in the U.S.
Probiotics have been advertised for a variety of conditions, including acute diarrhea, allergies, respiratory infections, irritable bowel syndrome, and inflammatory bowel disease. In addition, potential clinical applications for probiotics currently being researched include colon and bladder cancer, diabetes, and graft-versus-host disease in transplant patients.
Unlike the situation for many vitamins and minerals, there is no recommended daily dosage for probiotics. The probiotic dosage listed on a dietary supplement product is typically based on a study that has reported a health effect for that type of bacterium. This dosage can vary between different strains of bacteria, as well as by health condition. Specific strains and dosages— if known—for antibiotic-associated diarrhea, vulvovaginal candidiasis, and the common cold are discussed later in this article. Probiotics are sensitive to environmental conditions such as heat, moisture, oxygen, and light. Consumers should take precautions when storing products containing probiotics and follow the instructions indicated on the product label.
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