Probiotics: an Update About Mechanisms and Quality
Jeroen Bosch Hospital, sHertogenbosch, The Netherland
In many countries one can observe a vastly expanding market for probiotics. These live organisms have mostly been isolated from nature and commercialized with a claim of being beneficial for health of an individual. Only at a later moment the scientific insights emerged for the mechanisms involved in conditions as acute gastro-enteritis, antibiotic-associated diarrhea, dysbiosis, infantile colic and others clinical situations.
Intestinal dysbiosis is associated with many chronic conditions in later (adult) lives and in this respect the quality of the microbiome in the first 1000 days of life is essential for an optimal composition later in life. Interferences in this early period could have adverse long-term consequences. In this respect (repeated) courses of antibiotic therapy could result in prolonged disturbances of the microbiome and the question arises if there a place for probiotic therapy for persistent dysbiosis.
Current evidence for probiotic therapy comes from well-characterized probiotic strains in well-defined clinical situations, but the probiotic market is overwhelmed by many other products and different strains. Many of these products do not contain the amounts or strains as labeled. Potential dangerous situations could emerge when these products contain pathogens. This presentation may help the clinician to make rational choices within the context of limited financial resources.
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