Trumm Drug

Probiotics and Microflora

Probiotic foods have recently become popular in the United States, although such products have been marketed for decades in Europe and Asia. Probiotics are defined as living organisms that, when administered in sufficient numbers, are beneficial to the host. One probiotic food is Activia. It is a line of yogurt containing Lactobacillus, Streptococcus thermophilus, and Bifidobacterium animalis bacteria, and it is advertised to aid regularity. While new to the U.S., Activia has been sold in Europe since 1987. Most probiotic products can be found in the dairy case of supermarkets or as dietary supplements. There are probiotic frozen yogurts and dairy-based drinks such as DanActive, a probiotic yogurt drink that contains Lactobacillus casei immunitas cultures. Its manufacturer (Dannon) indicates that the product is clinically proven to “help strengthen your body’s defenses.” Products sold in the pharmacy include, among others, Culturelle (Lactobacillus GG), Florastor (Saccharomyces boulardii) and Lactinex (Lactobacillus acidophilus, Lactobacillus bulgaricus), which are indicated to reduce the chance of developing diarrhea due to antibiotics. The FDA takes a neutral position on probiotics, policing food packages to ensure that companies do not try to equate probiotic products with disease-curing drugs.
The growth of probiotics comes as many scientists are now focused on the role of beneficial bacteria to aid digestion, boost natural defenses, and fight off bacteria that could cause health problems. Intestinal bacteria can benefit health by breaking down toxins, synthesizing vitamins, and defending against infection. They may also play a role in preventing such diseases as peptic ulcers, colorectal cancer, and inflammatory bowel disease.
Recent evidence has shown that microbes and their genes play important roles in the development of our immune systems, in the production of fatty acids that enhance healthy intestinal cell growth, in elaborating molecules that inhibit the growth and virulence of enteric bacterial pathogens, and in the detoxification of ingested substances that could otherwise lead to cancerous cell growth or alter our ability to metabolize medicines. Pharmacists will thus become more involved in counseling patients interested in taking probiotics. In Europe, probiotics are regarded as medicines and prescribed along with antibiotics. In the U.S., pharmacists can advise patients to take such probiotic products as Culturelle, Florastor, or Lactinex while on antibiotics and for 3 to 7 days thereafter. The same products can be taken to help prevent traveler’s diarrhea. They should be taken a few days before the trip and continued through its duration. If your looking to decrease antbiotic induced diarrhea you need to separate any probiotic and antibiotic doses by 2 hours to prevent the antibiotic from destroying the probiotic organisms. Immunocompromised patients should be advised not to use probiotics because of the potential for systemic infections. Other side effects can include GI upset (e.g., flatulence, discomfort).
References: “U.S. Pharmacist” Dec. 2009