College of Pharmacy, Southwestern Oklahoma State University, Norman Regional Health System, Pharmacy Services, Norman, OK 73070-1308, USA.
Am J Health Syst Pharm. 2010 Mar 15;67(6):449-58. doi: 10.2146/ajhp090168.
The pharmacology, uses, dosages, safety, drug interactions, and contraindications of probiotics are reviewed.
Probiotics are live nonpathogenic microorganisms administered to improve microbial balance, particularly in the gastrointestinal tract. They consist of Saccharomyces boulardii yeast or lactic acid bacteria, such as Lactobacillus and Bifidobacterium species, and are regulated as dietary supplements and foods. Probiotics exert their beneficial effects through various mechanisms, including lowering intestinal pH, decreasing colonization and invasion by pathogenic organisms, and modifying the host immune response. Probiotic benefits associated with one species or strain do not necessarily hold true for others. The strongest evidence for the clinical effectiveness of probiotics has been in the treatment of acute diarrhea, most commonly due to rotavirus, and pouchitis. More research is needed to clarify the role of probiotics for preventing antibiotic-associated diarrhea, Clostridium difficile infection, travelers' diarrhea, irritable bowel syndrome, ulcerative colitis, Crohn's disease, and vulvovaginal candidiasis. There is no consensus about the minimum number of microorganisms that must be ingested to obtain a beneficial effect; however, a probiotic should typically contain several billion microorganisms to increase the chance that adequate gut colonization will occur. Probiotics are generally considered safe and well tolerated, with bloating and flatulence occurring most frequently. They should be used cautiously in patients who are critically ill or severely immunocompromised or those with central venous catheters since systemic infections may rarely occur. Bacteria-derived probiotics should be separated from antibiotics by at least two hours.
Probiotics have demonstrated efficacy in preventing and treating various medical conditions, particularly those involving the gastrointestinal tract. Data supporting their role in other conditions are often conflicting.
综述益生菌的药理学、用途、剂量、安全性、药物相互作用和禁忌证。
益生菌是给予的活非致病性微生物，用以改善微生物平衡，特别是在胃肠道中。它们由布拉氏酵母菌或乳酸菌组成，如乳杆菌属和双歧杆菌属，作为膳食补充剂和食品进行监管。益生菌通过多种机制发挥其有益作用，包括降低肠道 pH 值、减少致病性生物体的定植和侵袭，以及改变宿主免疫反应。与一种或一种菌株相关的益生菌益处不一定适用于其他菌株。益生菌临床疗效的最强证据是治疗急性腹泻，最常见的原因是轮状病毒和袋炎。需要更多的研究来阐明益生菌在预防抗生素相关性腹泻、艰难梭菌感染、旅行者腹泻、肠易激综合征、溃疡性结肠炎、克罗恩病和外阴阴道念珠菌病中的作用。对于获得有益效果必须摄入的最小微生物数量没有共识；然而，益生菌通常应含有数十亿个微生物，以增加充分肠道定植的机会。益生菌通常被认为是安全且耐受良好的，最常出现腹胀和胀气。由于全身性感染可能很少发生，因此应谨慎用于患有重病或严重免疫功能低下或有中心静脉导管的患者。细菌衍生的益生菌应与抗生素至少间隔两小时使用。
益生菌在预防和治疗各种医学病症方面已显示出疗效，特别是那些涉及胃肠道的病症。支持其在其他病症中作用的数据往往存在冲突。
