What is it?
Lactobacillus is used for treating and preventing diarrhea, including infectious types such as rotaviral diarrhea in children and traveler's diarrhea. It is also used to prevent and treat diarrhea associated with using antibiotics.
Some people use lactobacillus for general digestion problems; irritable bowel syndrome (IBS); colic in babies; Crohn's disease; inflammation of the colon; and a serious gut problem called necrotizing enterocolitis (NEC) in babies born prematurely. Lactobacillus is also used for infection with Helicobacter pylori, the type of bacteria that causes ulcers, and also for other types of infections including urinary tract infections (UTIs), vaginal yeast infections, to prevent the common cold in adults, and to prevent respiratory infections in children attending daycare centers. It is also being tested to prevent serious infections in people on ventilators.
Lactobacillus is used for skin disorders such as fever blisters, canker sores, eczema (allergic dermatitis); and acne.
It is also used for high cholesterol, lactose intolerance, Lyme disease, hives, and to boost the immune system.
Women sometimes use lactobacillus suppositories to treat vaginal infections and urinary tract infections (UTIs).
There are concerns about the quality of some lactobacillus products. Some products labeled to contain Lactobacillus acidophilus actually contain no lactobacillus acidophilus, or they contain a different strain of lactobacillus such as Lactobacillus bulgaricus. Some products are contaminated with “unfriendly” bacteria.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for LACTOBACILLUS are as follows:
Likely effective for...
- Diarrhea in children caused by a certain virus (rotavirus). Children with rotaviral diarrhea who are being treated with lactobacillus seem to get over their diarrhea about a half day earlier than they would without this treatment. Larger doses of lactobacillus are more effective than smaller ones. At least 10 billion colony-forming units during the first 48 hours should be used.
Possibly effective for...
- Preventing diarrhea in children caused by antibiotics. Giving children Lactobacillus GG (Culturelle) along with antibiotics seems to reduce the diarrhea that children sometimes experience when taking antibiotics alone.
- Preventing diarrhea in hospitalized adults. Drinking a specific beverage containing Lactobacillus casei, Lactobacillus bulgaricus, and Streptococcus thermophilus (Actimel, Danone) twice daily during antibiotic treatment and for a week afterwards significantly decreases the risk of developing diarrhea.
- Preventing diarrhea due to traveling. Traveler’s diarrhea is caused by bacteria, viruses, or parasites that the traveler has not been exposed to before. Taking a specific strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle) seems to help prevent diarrhea in travelers. The effectiveness of Lactobacillus GG can vary a lot depending on the travel destination because of differences in bacteria in different locations.
- Preventing diarrhea due to cancer treatment (chemotherapy). A chemotherapy drug called 5-fluorouracil can cause severe diarrhea and other gastrointestinal (GI) side effects. There is some evidence that patients with cancer of the colon or rectum have less severe diarrhea, less stomach discomfort, shorter hospital care, and require fewer chemotherapy dose reductions due to GI side effects when they take a particular strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle).
- Colic in babies. Taking a specific Lactobacillus reuteri product (Probiotic Drops, BioGaia AB) 100 million CFUs once daily for 21-28 days reduces daily crying time in nursing infants. Taking this Lactobacillus reuteri product seems to be more effective than using the drug simethicone.
- Lung infections. Children ages 1 to 6 years who attend daycare centers seem to get fewer and less severe lung infections when given milk containing lactobacillus GG or a specific combination product containing both Lactobacillus acidophilus and Bifidobacterium (HOWARU Protect).
- Treating a bowel condition called ulcerative colitis. Some research suggests that taking a specific combination product containing lactobacillus, bifidobacteria, and streptococcus might improve symptoms. Taking lactobacillus also seems to help treat chronic pouchitis, a complication of surgery for ulcerative colitis. Continuous treatment for one year with a specific concentrated formulation of lactobacillus, bifidobacterium, and streptococcus (VSL#3) seems to help most patients.
- Treating irritable bowel syndrome (IBS). There is some research showing that certain strains of lactobacillus, but not others, can improve symptoms of IBS such as bloating, and stomach pain.
- Treating vaginal infections caused by bacteria (bacterial vaginosis). Clinical research shows certain strains of Lactobacillus might help treat bacterial vaginosis when applied inside the vagina. Researchers have found Lactobacillus acidophilus suppositories (Vivag, Pharma Vinci A/S, Denmark) and vaginal tablets (Gynoflor, Medinova, Switzerland) may be effective. Researchers also found that vaginal capsules Lactobacillus gasseri and Lactobacillus rhamnosus, seem to lengthen the time between infections.
- Treating and preventing eczema (atopic dermatitis) in infants and children who are allergic to cow’s milk. A combination of freeze-dried Lactobacillus rhamnosus and Lactobacillus reuteri seems to reduce eczema symptoms in children ages 1 to 13 years.
- Helping prescription medications treat Helicobacter pylori (H pylori) infection, which causes stomach ulcers.
- Treating diarrhea caused by the bacterium Clostridium difficile.
Possibly ineffective for...
- Vaginal yeast infections after taking antibiotics. There is evidence that taking lactobacillus by mouth or eating yogurt enriched with lactobacillus doesn’t prevent vaginal yeast infections after antibiotics. However, women with yeast infections who use vaginal suppositories containing 1 billion live Lactobacillus GG bacteria twice daily for 7 days in combination with conventional treatment often report their symptoms improve.
- Crohn's disease.
- Lactose intolerance.
- Reducing symptoms of too much bacteria in the intestines.
Insufficient evidence to rate effectiveness for...
- Urinary tract infections (UTIs). There is some preliminary evidence that vaginal use of some Lactobacillus species might be helpful for preventing UTIs, but not all studies have agreed.
- General digestion problems.
- Necrotizing enterocolitis (NEC) in babies born prematurely.
- High cholesterol.
- Sensitivity to milk (lactose-intolerance).
- Lyme disease.
- Fever blisters.
- Canker sores.
- Boosting the immune system.
- Common cold.
- Preventing infections in people on ventilators.
- Other conditions.
How does it work?
Are there safety concerns?
Lactobacillus is also LIKELY SAFE for women to use inside the vagina.
Special precautions & warnings:Pregnancy and breast-feeding: Using lactobacillus during pregnancy and breast-feeding is POSSIBLY SAFE. Lactobacillus GG has been used safely in pregnant and breast-feeding women. But other types of lactobacillus have not been studied during pregnancy and breast-feeding, so their safety is unknown.
Weakened immune system: There is some concern that lactobacillus from supplements that contain live bacteria might grow too well in people whose immune systems are weakened. This includes people with HIV/AIDS or people who have taken medicines to prevent rejection of a transplanted organ. Lactobacillus has caused disease (rarely) in people with weakened immune systems. To be on the safe side, if you have a weakened immune system, talk with your healthcare provider before taking lactobacillus.
Short bowel syndrome: People with short bowel syndrome might be more likely than other people to develop lactobacillus infections. If you have this condition, talk with your healthcare provider before taking lactobacillus.
Are there interactions with medications?
- Antibiotic drugs
- Antibiotics are used to reduce harmful bacteria in the body. Antibiotics can also reduce friendly bacteria in the body. Lactobacillus is a type of friendly bacteria. Taking antibiotics along with lactobacillus can reduce the effectiveness of lactobacillus. To avoid this interaction, take lactobacillus products at least 2 hours before or after antibiotics.
- Medications that decrease the immune system (Immunosuppressants)
- Lactobacillus contains live bacteria and yeast. The immune system usually controls bacteria and yeast in the body to prevent infections. Medications that decrease the immune system can increase your chances of getting sick from bacteria and yeast. Taking lactobacillus along with medications that decrease the immune system might increase the chances of getting sick.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.
Are there interactions with herbs and supplements?
- There are no known interactions with herbs and supplements.
Are there interactions with foods?
- There are no known interactions with foods.
What dose is used?
The following doses have been studied in scientific research:
- For children with rotaviral diarrhea: 5 to 10 billion live Lactobacillus GG in a solution that replaces lost water.
- For treating babies and children with diarrhea:
- 10 to 100 billion live Lactobacillus reuteri daily for up to 5 days. Lower doses may not be effective.
- Also, combination of Lactobacillus rhamnosus and Lactobacillus reuteri, 10 billion live cells of each strain, twice daily for 5 days.
- For preventing antibiotic-associated diarrhea in children: A specific strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle) containing 20 billion live organisms daily has been used during treatment with antibiotics. A specific beverage containing Lactobacillus casei, Lactobacillus bulgaricus, and Streptococcus thermophilus (Actimel, Danone) 97 mL twice daily also has been used.
- For preventing diarrhea in infants and children ages 1 to 36 months:
- 6 billion live Lactobacillus GG twice daily.
- A fermented milk product containing a specific Lactobacillus casei strain DN-114 001 (DanActive, Dannon) in doses of 100 grams, 125 grams, or 250 grams daily has also been used.
- For preventing and shortening the duration of diarrhea in newborns within the first year of life in rural areas of developing countries: 100 million live Lactobacillus sporogenes have been given daily for one year.
- For preventing respiratory infections in children attending day-care centers: 260 mL milk with 500,000 to 1 million colony-forming units of Lactobacillus GG per mL. A milk product containing 5 billion colony forming units each of Lactobacillus acidophilus and Bifidobacterium (HOWARU Protect, Danisco) in 120 mL of milk twice a day has also been used. A milk product containing Lactobacillus 5 billion colony forming units in 120 mL of milk twice a day has also been used.
- For treating recurrent diarrhea caused by Clostridium difficile: 1.25 billion live Lactobacillus GG in two divided doses for 2 weeks.
- For ulcerative colitis: a combination product containing living freeze-dried bacteria species including lactobacillus, bifidobacteria, and streptococcus (VSL#3) 3 grams twice daily has been used for maintenance therapy.
- For patients with active mild-to-moderate ulcerative colitis: VSL#3 three grams once or twice daily in combination with conventional treatment.
- For children with moderate-to-severe ulcerative colitis: VSL#3 450-1800 billion bacteria once a day in combination with mesalamine.
- For preventing traveler's diarrhea: Lactobacillus GG, 2 billion organisms daily.
- For diarrhea due to chemotherapy: a specific strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle) containing 10-20 billion live organisms daily.
- For atopic dermatitis: a specific strain of Lactobacillus rhamnosus, Lactobacillus GG (Culturelle). Lactobacillus reuteri 100 million live bacteria daily, or Lactobacillus sakei 5 billion live bacteria twice daily have also been used.
- For irritable bowel syndrome (IBS): 10 billion heat-killed Lactobacillus acidophilus (Lacteol Fort) twice daily for 6 weeks. A specific lactobacillus combination probiotic containing viable lyophilized bacteria species including lactobacillus, bifidobacteria, and streptococcus (VSL#3) containing 450 billion viable lyophilized bacteria twice daily. A specific beverage containing Lactobacillus plantarum 299v (ProViva, Skanemejerier, Sweden) taken twice daily.
- For preventing the common cold in adults: a mixture of Lactobacillus plantarum and Lactobacillus paracasei, 1 billion live bacteria daily.
- For colic in babies: A specific Lactobacillus reuteri product (Probiotic Drops, BioGaia AB) 100 million CFUs once daily 30 minutes after a feeding.
- For preventing the serious gut condition called necrotizing enterocolitis (NEC) in babies born prematurely: Lactobacillus rhamnosus GG 6 billion live bacteria daily.
- For preventing serious lung infections in adults on ventilators: Lactobacillus rhamnosus GG (Amerifit Brands Nutrition), 2 billion live bacteria twice daily.
- For treating vaginal infections caused by bacteria:
- 1-2 vaginal tablets (Gynoflor, Medinova, Switzerland) daily containing living Lactobacillus acidophilus (10 million colon-forming units/tablet) and 0.3 mg estriol for 6 days.
- Intravaginal suppositories containing 100 million to 1 billion colony forming units of Lactobacillus acidophilus (Vivag, Pharma Vinci A/S, Denmark) given twice daily for 6 days has also been used.
- Vaginal capsules containing Lactobacillus gasseri and Lactobacillus rhamnosus, 100 million to 1 billion colony-forming units of each strain per capsule (EcoVag Vaginal Capsules, Bifodan A/S, Denmark), following usual treatment, for 10 days in three menstrual cycles following the infection has also been used.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
- Savino F, Pelle E, Palumeri E, et al. Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics 2007;119:e124-30. View abstract.
- Luoto R, Matomäki J, Isolauri E, Lehtonen L. Incidence of necrotizing enterocolitis in very-low-birth-weight infants related to the use of Lactobacillus GG. Acta Paediatr 2010;99:1135-8. View abstract.
- Romano C, Ferrau' V, Cavataio F, et al. Lactobacillus reuteri in children with functional abdominal pain (FAP). J Paediatr Child Health 2010 Jul 8. [Epub ahead of print]. View abstract.
- Berggren A, Lazou Ahrén I, Larsson N, Onning G. Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections. Eur J Nutr 2011;50:203-10. View abstract.
- Savino F, Cordisco L, Tarasco V, et al. Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics 2010;126:e526-33. View abstract.
- Woo SI, Kim JY, Lee YJ, et al. Effect of Lactobacillus sakei supplementation in children with atopic eczema-dermatitis syndrome. Ann Allergy Asthma Immunol 2010;104:343-8. View abstract.
- Morrow LE, Kollef MH, Casale TB. Probiotic prophylaxis of ventilator-associated pneumonia: a blinded, randomized, controlled trial. Am J Respir Crit Care Med 2010;182:1058-64. View abstract.
- Leyer GJ, Li S, Mubasher ME, et al. Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 2009;124:e172-e179. View abstract.
- Miele E, Pascarella F, Giannetti E. et al. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol 2009;104:437-43. View abstract.
- Niedzielin K, Kordecki H, Birkenfeld B. A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol 2001;13:1143-7. View abstract.
- Larsson PG, Stray-Pedersen B, Ryttig KR, Larsen S. Human lactobacilli as supplementation of clindamycin to patients with bacterial vaginosis reduce the recurrence rate; a 6-month, double-blind, randomized, placebo-controlled study. BMC Womens Health 2008;8:3. View abstract.
- Abrahamsson TR, Jakobsson T, Bottcher MF, et al. Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol 2007;119:1174-80.. View abstract.
- Hickson M, D'Souza AL, Muthu N, et al. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ 2007;335:80. View abstract.
- Mustapha A, Jiang T, Savaiano DA. Improvement of lactose digestion by humans following ingestion of unfermented acidophilus milk: influence of bile sensitivity, lactose transport, and acid tolerance of Lactobacillus acidophilus. J Dairy Sci 1997;80:1537-45. View abstract.
- Lin MY, Yen CL, Chen SH. Management of lactose maldigestion by consuming milk containing lactobacilli. Dig Dis Sci 1998;43:133-7. View abstract.
- Osterlund P, Ruotsalainen T, Korpela R, et al. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer 2007;97:1028-34. View abstract.
- Marteau P, Lemann M, Seksik P, et al. Ineffectiveness of Lactobacillus johnsonii LA1 for prophylaxis of postoperative recurrence in Crohn's disease: a randomised, double blind, placebo controlled GETAID trial. Gut 2006;55:842-7. View abstract.
- Kuhbacher T, Ott SJ, Helwig U, et al. Bacterial and fungal microbiota in relation to probiotic therapy (VSL#3) in pouchitis. Gut 2006;55:833-41. View abstract.
- Pedone CA, Arnaud CC, Postaire ER, et al. Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract 2000;54:589-71. View abstract.
- Pedone CA, Bernabeu AO, Postaire ER, et al. The effect of supplementation with milk fermented by Lactobacillus casei (strain DN-114 001) on acute diarrhoea in children attending day care centres. Int J Clin Pract 1999;53:179-84. View abstract.
- Bibiloni R, Fedorak RN, Tannock GW, et al. VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis. Am J Gastroenterol 2005;100:1539-46. View abstract.
- Tursi A, Brandimarte G, Giorgetti GM, et al. Low-dose balsalazide plus a high-potency probiotic preparation is more effective than balsalazide alone or mesalazine in the treatment of acute mild-to-moderate ulcerative colitis. Med Sci Monit 2004;10:PI126-31. View abstract.
- Yli-Knuuttila H, Snall J, Kari K, Meurman JH. Colonization of Lactobacillus rhamnosus GG in the oral cavity. Oral Microbiol Immunol 2006;21:129-31. View abstract.
- McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol 2006;101:812-22. View abstract.
- Hallen A, Jarstrand C, Pahlson C. Treatment of bacterial vaginosis with lactobacilli. Sex Transm Dis 1992;19:146-8.. View abstract.
- Parent D, Bossens M, Bayot D, et al. Therapy of bacterial vaginosis using exogenously-applied Lactobacilli acidophili and a low dose of estriol: a placebo-controlled multicentric clinical trial. Arzneimittelforschung 1996;46:68-73. . View abstract.
- De Groote MA, Frank DN, Dowell E, et al. Lactobacillus rhamnosus GG bacteremia associated with probiotic use in a child with short gut syndrome. Pediatr Infect Dis J 2005;24:278-80. View abstract.
- O'Mahony L, McCarthy J, Kelly P, et al. Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology 2005;128:541-51. View abstract.
- Land MH, Rouster-Stevens K, Woods CR, et al. Lactobacillus sepsis associated with probiotic therapy. Pediatrics 2005;115:178-81. View abstract.
- Rosenfeldt V, Benfeldt E, Nielsen SD, et al. Effect of probiotic Lactobacillus strains in children with atopic dermatitis. J Allergy Clin Immunol 2003;111:389-95. View abstract.
- O'Sullivan MA, O'Morain CA. Bacterial supplementation in the irritable bowel syndrome. A randomised double-blind placebo-controlled crossover study. Dig Liver Dis 2000;32:294-301. View abstract.
- Sen S, Mullan MM, Parker TJ, et al. Effect of Lactobacillus plantarum 299v on colonic fermentation and symptoms of irritable bowel syndrome. Dig Dis Sci 2002;47:2615-20. View abstract.
- Mimura T, Rizzello F, Helwig U, et al. Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis. Gut 2004;53:108-14. View abstract.
- Prantera C, Scribano ML, Falasco G, et al. Ineffectiveness of probiotics in preventing recurrence after curative resection for Crohn's disease: a randomised controlled trial with Lactobacillus GG. Gut 2002;51:405-9. View abstract.
- Wendakoon CN, Thomson AB, Ozimek L. Lack of therapeutic effect of a specially designed yogurt for the eradication of Helicobacter pylori infection. Digestion 2002;65:16-20. View abstract.
- Sakamoto I, Igarashi M, Kimura K, et al. Suppressive effect of Lactobacillus gasseri OLL 2716 (LG21) on Helicobacter pylori infection in humans. J Antimicrob Chemother 2001;47:709-10. View abstract.
- Felley CP, Corthesy-Theulaz I, Blanco Rivero JL, et al. Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man. Eur J Gastroenterol Hepatol 2001;13:25–9. View abstract.
- Cremonini F, Di Caro S, Covino M, et al. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol 2002;97:2744-9. View abstract.
- Vanderhoof JA, Young RJ. Current and potential uses of probiotics. Ann Allergy Asthma Immunol 2004;93:S33-7. View abstract.
- Pirotta M, Gunn J, Chondros P, et al. Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomized, controlled trial. BMJ 2004;329:548. View abstract.
- Majamaa H, Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol 1997;99:179-85. . View abstract.
- Sullivan A, Barkholt L, Nord CE. Lactobacillus acidophilus, Bifidobacterium lactis and Lactobacillus F19 prevent antibiotic-associated ecological disturbances of Bacteroides fragilis in the intestine. J Antimicrob Chemother 2003;52:308-11. View abstract.
- Kalliomaki M, Salminen S, Poussa T, et al. Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet 2003;361:1869-71. View abstract.
- Wei H, Loimaranta V, Tenovuo J, et al. Stability and activity of specific antibodies against Streptococcus mutans and Streptococcus sobrinus in bovine milk fermented with Lactobacillus rhamnosus strain GG or treated at ultra-high temperature. Oral Microbiol Immunol 2002;17:9-15. View abstract.
- Kim HJ, Camilleri M, McKinzie S, et al. A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 2003;17:895-904. . View abstract.
- Wullt M, Hagslatt ML, Odenholt I. Lactobacillus plantarum 299v for the treatment of recurrent Clostridium difficile-associated diarrhoea: a double-blind, placebo-controlled trial. Scand J Infect Dis 2003;35:365-7. . View abstract.
- Nobaek S, Johansson ML, Molin G, et al. Alteration of intestinal microflora is associated with reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol 2000;95:1231-8.. View abstract.
- Oksanen PJ, Salminen S, Saxelin M, et al. Prevention of travellers' diarrhoea by Lactobacillus GG. Ann Med 1990;22:53-6.. View abstract.
- Van Niel CW, Feudtner C, Garrison MM, Christakis DA. Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics 2002;109:678-84. View abstract.
- Rosenfeldt V, Michaelsen KF, Jakobsen M, et al. Effect of probiotic Lactobacillus strains in young children hospitalized with acute diarrhea. Pediatr Infect Dis J 2002;21:411-6. View abstract.
- Rosenfeldt V, Michaelsen KF, Jakobsen M, et al. Effect of probiotic Lactobacillus strains on acute diarrhea in a cohort of nonhospitalized children attending day-care centers. Pediatr Infect Dis J 2002;21:417-9. View abstract.
- Hatakka K, Savilahti E, Ponka A, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ 2001;322:1327. View abstract.
- Friend BA, Shahani KM. Nutritional and therapeutic aspects of lactobacilli. J Appl Nut 1984;36:125-153.
- Losada MA, Olleros T. Towards a healthier diet for the colon: the influence of fructooligosaccharides and lactobacilli on intestinal health. Nutr Res 2002;22:71-84.
- Canducci F, Armuzzi A, Cremonini F, et al. A lyophilized and inactivated culture of Lactobacillus acidophilus increases Helicobacter pylori eradication rates. Aliment Pharmacol Ther 2000;14:1625-9. View abstract.
- MacGregor G, Smith AJ, Thakker B, Kinsella J. Yoghurt biotherapy: contraindicated in immunosuppressed patients? Postgrad Med J 2002;78:366-7. View abstract.
- Cadieux P, Burton J, Gardiner G, et al. Lactobacillus strains and vaginal ecology. JAMA 2002;287:1940-1. View abstract.
- St-Onge MP, Farnworth ER, Jones PJ. Consumption of fermented and nonfermented dairy products: effects on cholesterol concentrations and metabolism. Am J Clin Nutr 2000;71:674-81. View abstract.
- Lu L, Walker WA. Pathologic and physiologic interactions of bacteria with the gastrointestinal epithelium. Am J Clin Nutr 2001;73;1124S-1130S. View abstract.
- Kalliomaki M, Salminen S, Arvilommi H et al. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet 2001;357:1076-1079. View abstract.
- Reid G. Probiotic agents to protect the urogenital tract against infection. Am J Clin Nutr 2001;73:437S-443S. View abstract.
- Isolauri E, Sutas Y, Kankaanpaa P, et al. Probiotics: effects on immunity. Am J Clin Nutr 2001;73:444S-450S. View abstract.
- D'Souza AL, Rajkumar C, Cooke J, Bulpitt CJ. Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis. BMJ 2002;324:1361. View abstract.
- Fujisawa T, Benno Y, Yaeshima T, Mitsuoka T. Taxonomic study of the Lactobacillus acidophilus group, with recognition of Lactobacillus gallinarum sp. nov. and Lactobacillus johnsonii sp. nov. and synonymy of Lactobacillus acidophilus group A3 (Johnson et al. 1980) with the type strain of Lactobacillus amylovorus (Nakamura 1981). Int J Syst Bacteriol 1992;42:487-91. View abstract.
- Doncheva NI, Antov GP, Softove EB, Nyagolov YP. Experimental and clinical study on the hypolipidemic and antisclerotic effect of Lactobacillus bulgaricus strain GB N 1 . Nutr Res 2002;22:393-403.
- Kishi A, Uno K, Matsubara Y, et al. Effect of the oral administration of Lactobacillus brevis subsp. coagulans on interferon-alpha producing capacity in humans. J Am Coll Nutr 1996;15:408-12. View abstract.
- Sheih YH, Chiang BL, Wang LH, et al. Systemic immunity-enhancing effects in healthy subjects following dietary consumption of the lactic acid bacterium Lactobacillus rhamnosus HN001. J Am Coll Nutr 2001;20:149-56. View abstract.
- Gill HS, Rutherfurd KJ. Probiotic supplementation to enhance natural immunity in the elderly: effects of a newly characterized immunostimulatory strain of Lactobacillus rhamnosus HN001 (DR20) on leucocyte phagocytosis. Nutr Res 2001;21:183-9.
- Casas IA, Dobrogosz WJ. Validation of the probiotic concept: Lactobacillus reuteri confers broad-spectrum protection against disease in humans and animals. Microbial Ecology in Health and Disease 2000;12:247-85.
- Madsen KL, Doyle JS, Jewell LD, et al. Lactobacillus species prevents colitis in interleukin 10 gene-deficient mice. Gastroenterology 1999;116:1107-14. View abstract.
- Shornikova AV, Casas IA, Mykkanen H, et al. Bacteriotherapy with Lactobacillus reuteri in rotavirus gastroenteritis. Pediatr Infect Dis J 1997;16:1103-7. View abstract.
- Wolf BW, Wheeler KB, Ataya DG, Garleb KA. Safety and tolerance of Lactobacillus reuteri supplementation to a population infected with the human immunodeficiency virus. Food Chem Toxicol 1998;36:1085-94 . View abstract.
- Shornikova AV, Casas IA, Isolauri E, et al. Lactobacillus reuteri as a therapeutic agent in acute diarrhea in young children. J Pediatr Gastroenterol Nutr 1997;24:399-404. View abstract.
- Kasravi FB, Adawi D, Molin G, et al. Effect of oral supplementation of lactobacilli on bacterial translocation in acute liver injury induced by D-galactosamine. J Hepatol 1997;26:417-24. View abstract.
- Alak JI, Wolf BW, Mdurvwa EG, et al. Effect of Lactobacillus reuteri on intestinal resistance to Cryptosporidium parvum infection in a murine model of acquired immunodeficiency syndrome. J Infect Dis 1997;175:218-21. View abstract.
- Palmfeldt J, Hahn-Hagerdal B. Influence of culture pH on survival of Lactobacillus reuteri subjected to freeze-drying. Int J Food Microbiol 2000;55:235-8. View abstract.
- Mao Y, Nobaek S, Kasravi B, et al. The effects of Lactobacillus strains and oat fiber on methotrexate-induced enterocolitis in rats. Gastroenterology 1996;111:334-44. View abstract.
- Wagner RD, Pierson C, Warner T, et al. Biotherapeutic effects of probiotic bacteria on candidiasis in immunodeficient mice. Infect Immun 1997;65:4165-4172. View abstract.
- Maggi L, Mastromarino P, Macchia S, et al. Technological and biological evaluation of tablets containing different strains of lactobacilli for vaginal administration. Eur J Pharm Biopharm 2000;50:389-95. View abstract.
- Halpern GM, Prindiville T, Blankenburg M, et al. Treatment of irritable bowel syndrome with Lacteol Fort: a randomized, double-blind, cross-over trial. Am J Gastroenterol 1996;91:1579-85. View abstract.
- Rautava S, Kalliomaki M, Isolauri E. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. J Allergy Clin Immunol 2002;109:119-21. View abstract.
- Chandra RK. Effect of Lactobacillus on the incidence and severity of acute rotavirus diarrhoea in infants. A prospective placebo-controlled double-blind study. Nutr Res 2001;22:65-9.
- Szajewska H, Kotowska M, Mrukowicz JZ, et al. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr 2001;138:361-5. View abstract.
- Thomas MR, Litin SC, Osmon DR, et al. Lack of effect of Lactobacillus GG on antibiotic-associated diarrhea: a randomized, placebo-controlled trial. Mayo Clin Proc 2001;76:883-9. View abstract.
- Roberfroid MB. Prebiotics and probiotics: are they functional foods? Am J Clin Nutr 2000;71:1682S-7S. View abstract.
- Gupta K, Stapleton AE, Hooton TM, et al. Inverse association of H2O2-producing Lactobacilli and vaginal Escherichia coli colonization in women with recurrent urinary tract infections. J Infect Dis 1998;178:446-50. View abstract.
- Reid G, Bruce AW, Taylor M. Influence of three-day antimicrobial therapy and lactobacillus vaginal suppositories on recurrence of urinary tract infections. Clin Ther 1992;14:11-6. View abstract.
- Bruce AW, Reid G. Intravaginal instillation of Lactobacilli for prevention of recurrent urinary tract infections. Can J Microbiol 1988;34:339-43. View abstract.
- Herthelius M, Gorbach SL, Mollby R, et al. Elimination of vaginal colonization with Escherichia coli by administration of indigenous flora. Infect Immun 1989;57:2447-51. View abstract.
- Chan RCY, Reid G, Irvin RT, et al. Competitive exclusion of uropathogens from human uroepithelial cells by Lactobacillus whole cells and cell wall fragments. Infect Immun 1985;47:84-9. View abstract.
- Reid G, Cook RL, Bruce AW. Examination of strains of lactobacilli for properties that may influence bacterial interference in the urinary tract. J Urol 1987;138:330-5. View abstract.
- Velraeds MM, van der Mei HC, Reid G, Busscher HJ. Inhibition of initial adhesion of uropathogenic Enterococcus faecalis by biosurfactants from Lactobacillus isolates. Appl Environ Microbiol 1996;62:1958-63. View abstract.
- McGroarty JA. Probiotic use of lactobacilli in the human female urogenital tract. FEMS Immunol Med Microbiol 1993;6:251-64. View abstract.
- Reid G, Bruce AW, Cook RL, et al. Effect on urogenital flora of antibiotic therapy for urinary tract infection. Scand J Infect Dis 1990;22:43-7. View abstract.
- Gionchetti P, Rizzello F, Venturi A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 2000;119:305-9. View abstract.
- Darouiche RO, Hull RA. Bacterial interference for prevention of urinary tract infection: an overview. J Spinal Cord Med 2000;23:136-41. View abstract.
- Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
- Alander M, Satokari R, Korpela R, et al. Persistence of colonization of human colonic mucosa by a probiotic strain, Lactobacillus rhamnosus GG, after oral consumption. Appl Environ Microbiol 1999;65:351-4. View abstract.
- Baerheim A, Larsen E, Digranes A. Vaginal application of lactobacilli in the prophylaxis of recurrent lower urinary tract infection in women. Scand J Prim Health Care 1994;12:239-43. View abstract.
- Pelto L, Ioslauri E, Lilius EM, et al. Probiotic bacteria down-regulate the milk-induced inflammatory response in milk-hypersensitive subjects but have an immunostimulatory effect in healthy subjects. Clin Exp Allergy 1998;28:1474-9. View abstract.
- Rautio M, Jousimies-Somer H, Kauma H, et al. Liver abscess due to Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG. Clin Infect Dis 1999;28:1159-60. View abstract.
- Hilton E, Rindos P, Isenberg HD. Lactobacillus GG Vaginal Suppositories and Vaginitis. J Clin Microbiol 1995;33:1433. View abstract.
- Biller JA, Katz AJ, Flores AF, et al. Treatment of recurrent Clostridium difficile colitis with Lactobacillus GG. J Pediatr Gastroenterol Nutr 1995;21:224-6. View abstract.
- Goldin BR. Health Benefits of probiotics. Br J Nutr 1998;80:S203-7. View abstract.
- Pochapin M. The effect of probiotics on Clostridium difficile diarrhea. Am J Gastroenterol 2000;95:S11-3. View abstract.
- Kalima P, Masterton RG, Roddie PH, et al. Lactobacillus rhamnosus infection in a child following bone marrow transplant. J Infect 1996;32:165-7. View abstract.
- Klein G, Zill E, Schindler R, et al. Peritonitis associated with vancomycin-resistant Lactobacillus rhamnosus in a continuous ambulatory peritoneal dialysis patient; organism identification, antibiotic therapy, and case report. J Clin Microbiol 1998;36:1781-3. View abstract.
- Tynkkynen S, Singh KV, Varmanen P. Vancomycin resistance factor of Lactobacillus rhamnosus GG in relation to enterococcal vancomycin resistance (van) genes. Int J Food Microbiol 1998;41:195-204. View abstract.
- Mack DR, Michail S, Shu W, et al. Probiotics inhibit enteropathogenic E. coli adherence in vitro by inducing intestinal mucin gene expression. Am J Physiol 1999;276(4 Pt 1):G941-50. View abstract.
- McIntosh GH, Royle PJ, Playne MJ. A probiotic strain of L. acidophilus reduces DMH-induced large intestinal tumors in male Sprague-Dawley rats. Nutr Cancer 1999;35:153-9. View abstract.
- Goldin BR, Gualtieri LJ, Moore RP. The effect of Lactobacillus GG on the initiation and promotion of DMH-induced intestinal tumors in the rat. Nutr Cancer 1996;25:197-204. View abstract.
- Saxelin M, Chuang NH, Chassy B, et al. Lactobacilli and bacteremia in southern Finland 1989-1992. Clin Infect Dis 1996;22:564-6. View abstract.
- Sutas Y, Hurme M, Isolauri E. Down-regulations of anti-CD3 antibody-induced IL-4 production by bovine caseins hydrolyzed with Lactobacillus GG-derived enzymes. Scand J Immunol 1996;43:687-9. View abstract.
- Hudault S, Lievin V, Bernet-Camard MF, Servin AL. Antagonistic activity exerted in vitro and in vivo by Lactobacillus casei (strain GG) against Salmonella typhimurium C5 infection. Appl Environ Microbiol 1997;63:513-8. View abstract.
- Guarino A, Canani RB, Spagnuolo MI, et al. Oral bacterial therapy reduces the duration of symptoms and of viral excretion in children with mild diarrhea. J Pediatr Gastroenterol Nutr 1997;25:516-9. View abstract.
- El-Nezami H, Kankaanpaa P, Salminen S, et al. Ability of dairy strains of lactic acid bacteria to bind a common food carcinogen, aflatoxin B1. Food Chem Toxicol 1998;36:321-6. View abstract.
- Hilton E, Kolakowski P, Singer C, et al. Efficacy of Lactobacillus GG as a Diarrheal Preventative in Travelers. J Travel Med 1997;4:41-3. View abstract.
- Oberhelman RA, Gilman RH, Sheen P, et al. A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. J Pediatr 1999;134:15-20. View abstract.
- Arvola T, Laiho K, Torkkeli S, et al. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics 1999;104:e64. View abstract.
- Vanderhoof JA, Whitney DB, Antonson DL, et al. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. J Pediatr 1999;135:564-8. View abstract.
- Guandalini S, Pensabene L, Zikri MA, et al. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial. J Pediatr Gastroenterol Nutr 2000;30:54. View abstract.
- de Roos NM, Katan MB. Effects of probiotic bacteria on diarrhea, lipid metabolism, and carcinogenesis: a review of papers published between 1988 and 1998. Am J Clin Nutr 2000;71:405-11. View abstract.
- Schultz M, Sartor RB. Probiotics and inflammatory bowel diseases. Am J Gastroenterol 2000;95:S19-21. View abstract.
- Gorbach SL. Probiotics and gastrointestinal health. Am J Gastroenterol 2000;95:S2-S4. View abstract.
- Venturi A, Gionchetti P, Rizzello F, et al. Impact on the composition of the faecal flora by a new probiotic preparation: preliminary data on maintenance treatment of patients with ulcerative colitis. Aliment Pharmacol Ther 1999;13:1103-8. View abstract.
- Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
- Isolauri E, Juntunen M, Rautanen T, et al. A human Lactobacillus strain (Lactobacillus casei sp strain GG) promotes recovery from acute diarrhea in children. Pediatrics 1991;8:90-7. View abstract.
- Shalev E, Battino S, Weiner E, et al. Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis. Arch Fam Med 1996;5:593-6. View abstract.
- Newcomer AD, Park HS, O'Brien PC, McGill DB. Response of patients with irritable bowel syndrome and lactase deficiency using unfermented acidophilus milk. Am J Clin Nutr 1983;38:257-63. View abstract.