Snydman David R
Division of Geographic Medicine and Infectious Diseases and Department of Medicine, Tufts-New England Medical Center, and Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
Clin Infect Dis. 2008 Feb 1;46 Suppl 2:S104-11; discussion S144-51. doi: 10.1086/523331.
Probiotics are generally defined as microorganisms that, when consumed, generally confer a health benefit on humans. There is considerable interest in probiotics for a variety of medical conditions, and millions of people around the world consume probiotics daily for perceived health benefits. Lactobacilli, bifidobacteria, and lactococci have generally been regarded as safe. There are 3 theoretical concerns regarding the safety of probiotics: (1) the occurrence of disease, such as bacteremia or endocarditis; (2) toxic or metabolic effects on the gastrointestinal tract; and (3) the transfer of antibiotic resistance in the gastrointestinal flora. In this review, the evidence for safety of the use of or the study of probiotics is examined. Although there are rare cases of bacteremia or fungemia related to the use of probiotics, epidemiologic evidence suggests no population increase in risk on the basis of usage data. There have been many controlled clinical trials on the use of probiotics that demonstrate safe use. The use of probiotics in clinical trials should be accompanied by the use of a data-safety monitoring board and by knowledge of the antimicrobial susceptibilities of the organism used.
益生菌通常被定义为摄入后一般会给人类带来健康益处的微生物。人们对益生菌用于多种医疗状况有着浓厚兴趣，全球数百万人每天食用益生菌以获取预期的健康益处。乳酸菌、双歧杆菌和乳球菌通常被认为是安全的。关于益生菌的安全性存在三个理论上的担忧：（1）疾病的发生，如菌血症或心内膜炎；（2）对胃肠道的毒性或代谢影响；（3）胃肠道菌群中抗生素耐药性的转移。在本综述中，对使用益生菌或研究益生菌的安全性证据进行了审查。虽然有罕见的与使用益生菌相关的菌血症或真菌血症病例，但流行病学证据表明，根据使用数据，人群风险并未增加。有许多关于使用益生菌的对照临床试验证明其使用是安全的。在临床试验中使用益生菌时，应配备数据安全监测委员会，并了解所使用菌株的抗菌敏感性。
