The DOI matches its Crossref record; 75 of the 75 references it cites were found in a registry or an index.
Probiotic use in clinical practice: what are the risks?
Open accessAbstract
Probiotics have been advocated for the prevention and treatment of a wide range of diseases, and there is strong evidence for their efficacy in some clinical scenarios. Probiotics are now widely used in many countries by consumers and in clinical practice. Given the increasingly widespread use of probiotics, a thorough understanding of their risks and benefits is imperative. In this article we review the safety of probiotics and discuss areas of uncertainty regarding their use. Although probiotics have an excellent overall safety record, they should be used with caution in certain patient groups-particularly neonates born prematurely or with immune deficiency. Because of the paucity of information regarding the mechanisms through which probiotics act, appropriate administrative regimens, and probiotic interactions, further investigation is needed in these areas. Finally, note that the properties of different probiotic species vary and can be strain-specific. Therefore, the effects of one probiotic strain should not be generalized to others without confirmation in separate studies. Careful consideration should be given to these issues before patients are advised to use probiotic supplements in clinical practice.
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“Immune compromise (including a debilitated state or malignancy) has been identified as a risk factor for rare cases of bacteraemia or fungaemia in patients taking certain probiotics (most commonly Saccharomyces boulardii).74,75”
From Systematic review: probiotics in the management of lower gastrointestinal symptoms in clinical practice - an evidence-based international guide (2013) · cites this paper as [75]
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“The general consensus is that probiotic ingestion is safe [221, 222], with large doses well tolerated and failing to exhibit any toxicity [223].”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [221]
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Citations
Cites
Host-Bacterial Mutualism in the Human Intestine
Bäckhed, F., Ley, R. E., Sonnenburg, J. L., Peterson, D. A., & Gordon, J. I. (2005) · Science · doi:10.1126/science.1104816 · Cited by 5,277
Recognition of Commensal Microflora by Toll-Like Receptors Is Required for Intestinal Homeostasis
Rakoff-Nahoum, S., Paglino, J., Eslami-Varzaneh, F., Edberg, S., & Medzhitov, R. (2004) · Cell · doi:10.1016/j.cell.2004.07.002 · Cited by 4,251
Wegmann, T. G., Lin, H., Guilbert, L., & Mosmann, T. R. (1993) · Immunology Today · doi:10.1016/0167-5699(93)90235-d · Cited by 2,852
Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial
Kalliomäki, M. A., Salminen, S., Arvilommi, H. S., Kero, P. O., Koskinen, P. J., & Isolauri, E. (2001) · The Lancet · doi:10.1016/s0140-6736(00)04259-8 · Cited by 2,443
Molecular Analysis of Commensal Host-Microbial Relationships in the Intestine
Hooper, L. V., Wong, M. H., Thelin, A., Hansson, L., Falk, P. G., & Gordon, J. I. (2001) · Science · doi:10.1126/science.291.5505.881 · Cited by 2,202
Guidelines for the evaluation of probiotics in food
Who, F. (2002) · Medical Entomology and Zoology · Cited by 1,843
Gionchetti, P., Rizzello, F., Venturi, A., Brigidi, P., Matteuzzi, D., Bazzocchi, G., Poggioli, G., Miglioli, M., & Campieri, M. (2000) · Gastroenterology · doi:10.1053/gast.2000.9370 · Cited by 1,485
Zoetendal, E. G., Akkermans, A. D. L., & de Vos, W. M. (1998) · Applied and Environmental Microbiology · doi:10.1128/aem.64.10.3854-3859.1998 · Cited by 1,360
Kelly, D., Campbell, J. I., King, T. P., Grant, G., Jansson, E. Å., Coutts, A., Pettersson, S., & Conway, S. (2003) · Nature Immunology · doi:10.1038/ni1018 · Cited by 1,026
Probiotics: A novel approach in the management of food allergy
Majamaa, H., & Isolauri, E. (1997) · Journal of Allergy and Clinical Immunology · doi:10.1016/s0091-6749(97)70093-9 · Cited by 929
Research works printed but not linked: 2
- 1996, Commission directive on processed cereal-based foods and baby foods for infants and young children. Luxemburg City, Luxembourg: European Commission,, L49, 17
- Lestin, 2003, Fungemia after oral treatment with Saccharomyces boulardii in a patient with multiple comorbidities, Dtsch Med Wochenschr, 128, 2531
Cited by
Sorted by citations
Items 601–700 of 773
Safety and Effectiveness of Probiotic Preparations: A Contemporary Review
Shorabaev, E., Sadanov, A. K., Baimakhanova, B. B., Ратникова, И. А., Xetayeva, G., Akhelova, S., & Turgumbayeva, A. (2026) · Diseases · doi:10.3390/diseases14090316 · Cited by 1
Activation of innate immune responses by non-pathogenic and pathogenic bacteria in human leukocytes
Latvala, S. (2014) · STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) · Cited by 1
Kutlu, T. (2011) · Türk Pediatri Arşivi · doi:10.4274/tpa.46.36 · Cited by 1
Probiotics and periodontal diseases: The link
Bali, D., Oberoi, S., Pandit, N., & Pandit, I. K. (2013) · Indian Journal of Oral Sciences · doi:10.4103/0976-6944.122953 · Cited by 1
Probiotics and Enteric Cancers
Liong, M., Lye, H., Yeo, S. K., Ewe, J., Ooi, L.-G., & Lim, T. (2011) · Springer eBooks · doi:10.1007/978-94-007-0386-5_17 · Cited by 1
Obtención de microorganismos con actividad probiótica para animales monogástricos
Hernández, Y. G. (2016) · Anales de la Academia de Ciencias de Cuba · Cited by 1
Probiotics: Manipulator of Periodontal Diseases?
Gupta, S., & Prabha, C. (2016) · Cited by 1
Chapter 20: Prebiotics and Probiotics
Kale-Pradhan, P. B., & Wilhelm, S. M. (2017) · The American Pharmacists Association eBooks · doi:10.21019/9781582122656.ch20 · Cited by 1
Christoforou, A., Norsen, S., & L’Abbé, M. R. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-802861-2.00036-5 · Cited by 1
Probiotic potential of Lactobacillus fermentum G-4 originating from the meconium of newborns
Zavišić, G., Petricevic, S. M., Ristić, S., Rikalović, M., Lješković, N. J., Begović, J., & Strahinić, I. (2019) · Journal of the Serbian Chemical Society · doi:10.2298/jsc181105015z · Cited by 1
Probiotics and Disease: A Comprehensive Summary-Part 4, Infectious Diseases.
Gasta, M. G., Williamson, C. B., Gossard, C. M., Pizano, J. M., Burns, C. M., Dolan, K. E., Finley, H. J., Parker, E., & Lipski, E. A. (2017) · Europe PMC (PubMed Central) · Cited by 1
Assessment of the Risk of Probiotics in Terms of the Food Safety and Human Health
Kalkan, S., Erginkaya, Z., Turhan, E. Ü., & Konuray, G. (2019) · Springer eBooks · doi:10.1007/978-3-030-24903-8_14 · Cited by 1
An overview of probiotic use in dentistry: a literature review
Alharith, D., Alhokair, R., Zakri, N., Alshaqha, N., Almutairi, M., & Alamri, M. K. (2020) · International Journal of Medicine in Developing Countries · doi:10.24911/ijmdc.51-1602155690 · Cited by 1
Glažar, I., Jokić, N. I., Bakarčić, D., Mišković, I., & Kuiš, D. (2014) · Cited by 1
Buriti, F. C. A., de Souza, C., & Saad, S. M. I. (2012) · CRC Press eBooks · doi:10.1201/b12084-50 · Cited by 1
Colic and Gastrointestinal Gas
Maheshwari, A., & Gupta, S. K. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-67293-1.00010-4 · Cited by 1
The Double Face of Bacteria and the Ambiguous Role of Some Probiotics
(2014) · CRC Press eBooks · doi:10.1201/b16439-11 · Cited by 1
Kiani, Z., Rouhani, M. H., Mahdavi, A., Askari, G., Jamialahmadi, T., Bagherniya, M., & Sahebkar, A. (2023) · Current Medicinal Chemistry · doi:10.2174/0929867331666230815104548 · Cited by 1
Benefits and safety of probiotics in gastrointestinal diseases
Profir, M., Roşu, O. A., Ionescu, R. F., Pavelescu, L. A., & Creţoiu, S. M. (2024) · Elsevier eBooks · doi:10.1016/b978-0-12-824472-2.00011-7 · Cited by 1
Nasr, A., & El-Aziz, M. S. A. (2013) · Cited by 1
Probiotic use in the prevention and therapy of atopic dermatitis
Prebeg, M., & Brajac, I. (2017) · Medicina · doi:10.21860/medflum2017_173386 · Cited by 1
Bakterielle Vaginose: von Dysbiose, Biofilmen und probiotischer Prophylaxe
Mendling, W. (2017) · gynäkologie + geburtshilfe · doi:10.1007/s15013-017-1243-7 · Cited by 1
Koh, J. Y., Seo, E., & Lee, J. (2017) · Pediatric Infection & Vaccine · doi:10.14776/piv.2017.24.3.168 · Cited by 1
Is the Probiotic Mixture Effective in the Treatment of TNBS-induced Experimental Colitis?
Utku, Ö. G., Karatay, E., Ergül, B., Yılmaz, C., Ekinci, Ö., & Arhan, M. (2020) · Journal of Academic Research in Medicine · doi:10.4274/jarem.galenos.2019.2247 · Cited by 1
Microbial Eukaryotic Diversity and Function Within the Human Gut Microbiota
Cevasco, M. E. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-819265-8.00096-6 · Cited by 1
SEGURANÇA NO USO DE PROBIÓTICOS EM PACIENTES IMUNOCOMPROMETIDOS
Unterkircher, M. V., Gomes, T. T., Cardoso, E., Nakasato, M., & Vieira, L. P. (2012) · Brazilian Journal of Transplantation · doi:10.53855/bjt.v15i2.181 · Cited by 1
Microbiome Therapeutics: Emerging Concepts and Challenges
Sarada, J., Anju, S., Aparna, Y., & Anuradha, K. T. (2021) · Springer eBooks · doi:10.1007/978-981-16-3156-6_11 · Cited by 1
Etika, R., Sudarmo, S. M., Suwarno, S., Mapindra, M. P., & Mahindra, M. P. (2021) · Paediatrica Indonesiana · doi:10.14238/pi61.6.2021.336-42 · Cited by 1
Determination of D-Lactic Acid Production
Pandey, S., Chaudhari, A., & Dwivedi, M. (2022) · Methods and protocols in food science · doi:10.1007/978-1-0716-2509-5_9 · Cited by 1
Probiotics and the gastrointestinal microbiota
Hickson, M. (2014) · doi:10.1002/9781118872796.ch2.3 · Cited by 1
Krysan, D. J. (2006) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2006.11.025 · Cited by 1
Microbial Ecology and Global Health
Teplitski, M., Leitão, J. H., & Sela, S. (2011) · International Journal of Microbiology · doi:10.1155/2011/564701 · Cited by 1
Can Lactobacillus Reuteri Prevent Allergic Disease in Early Childhood
Abrahamsson, T. (2009) · DiVA (Linkoping University) · Cited by 1
Initiating a practice change: Prescribing probiotics concurrently with antibiotic therapy
Hermosilla, P. (2009) · doi:10.33915/etd.3507 · Cited by 1
Clostridium difficile: new challenges for an old foe
Tillotson, G., & Weiss, K. (2013) · doi:10.2217/ebo.13.271 · Cited by 1
Probiotic use in the critically ill
Morrow, L. E., Gogineni, V. K., & Malesker, M. A. (2014) · doi:10.2217/ebo.13.573 · Cited by 1
Role of Probiotics in Medical Practice
Mollah, M. A. H., & Pervez, M. (2018) · Journal of Bangladesh College of Physicians and Surgeons · doi:10.3329/jbcps.v36i2.36064 · Cited by 1
Lack, G., & Toit, G. D. (2013) · Wiley eBooks · doi:10.1002/9781118744185.ch38 · Cited by 1
Wong, S. (2019) · City Research Online (City University London) · Cited by 1
Immune modulating nutrients in small animals
Chan, D. L. (2015) · Wiley eBooks · doi:10.1002/9781119052951.ch18
Dietary and Nutritional Supplements
Edman, J. S., & Horvitz, E. (2007) · doi:10.1002/9780470691793.ch13
Other Organism‐Based Processes and Products
Lee, B. H. (2014) · doi:10.1002/9781118384947.ch5
Developing effective probiotic products: bioavailability and other factors
Lahtinen, S. J., Rautonen, N., Ouwehand, A. C., Henrikson, A., & Steele, P. M. (2009) · Elsevier eBooks · doi:10.1533/9781845696603.1.230
Evaluating patient susceptibility in Clostridium difficile infection
Islam, J. (2013) · University of Brighton Repository (University of Brighton)
Efeitos do consumo de probióticos nos lípides sangüíneos
Manzoni, M. S. J., Cavallini, D., & Rossi, E. A. (2008) · DOAJ (DOAJ: Directory of Open Access Journals)
Role of Integrative Medicine in Liver Transplantation
Bazzan, A. J., Newberg, A. B., & Monti, D. (2016) · Springer eBooks · doi:10.1007/978-3-319-05543-5_31-2
Hickey, Y. (2012) · Arrow - TU Dublin (Technological University Dublin) · doi:10.21427/d7nj10
Investigation of host-microbe interactions in the probiotic bacteria Escherichia coli Nissle 1917
Nzakizwanayo, J. (2014) · University of Brighton Repository (University of Brighton)
Gąsiorowska, J., & Czerwionka‐Szaflarska, M. (2010) · Pediatria Polska · doi:10.1016/s0031-3939(10)70563-1
Los probióticos pueden contrarrestar la diarrea asociada a antibióticos
Yantis, M. A., & Velander, R. (2009) · Nursing (Ed española) · doi:10.1016/s0212-5382(09)70642-9
Chronic Immune Activation is the Cause of AIDS: Implication of Treatment in the Developing World
Malykhina, O. (2015) · Journal of Human Virology & Retrovirology · doi:10.15406/jhvrv.2015.02.00034
Fórmulas especializadas en gastroenterología
Reyes, G., & Elisa, M. E. C. (2011) · Revista Portuguesa de Pneumologia
Probiotics, with special emphasis on their role in the management of irritable bowel syndrome
Stevenson, C., & Blaauw, R. (2012) · Pharmacy management
Sarowska, J., Choroszy−Król, I., Frej−Mądrzak, M., & Jama−Kmiecik, A. (2013)
Sindhu, S. C., Khetarpaul, N., & Sindhu, A. (2013)
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Sb, E., Rd, S., Fs, D., Chandru, T., Bm, S., & Dental, G. (2014) · International Journal of Pharma and Bio Sciences
Israel, D., Padilla, D. P. R., Hurle, L. P., García-Sorrondegui, F. I., & Brito, R. S. (2012) · Dialnet (Universidad de la Rioja)
Editorial Commentary: The Gut Microbiota Strikes Again
Poutsiaka, D. D. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/civ292
Pro- and Prebiotics for the Prevention and Treatment of Diseases in Childhood
Haschke‐Becher, E., & Haschke, F. (2012) · Humana Press eBooks · doi:10.1007/978-1-62703-254-4_21
DENTAL CARIES PREVENTION: A REVIEW OF CONVENTIONAL AND RECENT PREVENTIVE APPROACHES
Pr, S., Kumar, D. V., & Bhardwaj, P. (2014) · Journal of medical and dental sciences
Suppression of Helicobacter Pylori in Mice Intestine by Ingestion of Lactic Acid Bacteria in Yoghurt
Ogeneh, B. O., Emenuga, V. N., Uche, O., & Enwelu Ngozika, J. (2014) · IOSR Journal of Dental and Medical Sciences · doi:10.9790/0853-13440912
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Grayson, E. (2014)
Quoting a landmark paper on the beneficial effects of probiotics
Steinke, J. W., Payne, S. C., Tessier, M., Borish, L. O., Han, J. K., & Borish, L. (2009)
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Probiotics in antibiotic associated diarrhea in children
Homan, M. (2013) · DOAJ (DOAJ: Directory of Open Access Journals)
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Empfehlungen zu Prä- und Probiotika in Säuglingsanfangsnahrungen
Reinhardt, D. (2009)
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Lombard, M. J., & Labuschagne, I. L. (2014) · Wageningen Academic Publishers eBooks · doi:10.3920/978-90-8686-223-8_19
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Kabra, S. K., & Lodha, R. (2011) · Science Publishers eBooks · doi:10.1201/b10770-10
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Cresci, G. (2015) · CRC Press eBooks · doi:10.1201/b18386-13
The Use of Prebiotics, Probiotics, and Synbiotics in the Critically Ill
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de la Cruz, D., & Neu, J. (2014) · CRC Press eBooks · doi:10.1201/b17311-13
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Soden, J. S. (2016) · Springer eBooks · doi:10.1007/978-3-319-42551-1_3
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Moni, S. C., Shamsuzzaman, S., & Shahidullah, M. (2017) · Bangladesh Journal of Medical Microbiology · doi:10.3329/bjmm.v8i1.31074
Wilcock, D. M. (2018) · J. Willard Marriott Library · doi:10.26053/0h-s53p-sj00
Renhe, I. R. T. (2013) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
Noorhosseini, S. (2016) · TSpace (University of Toronto)
The microbiome andClostridium difficileinfection
Chiu, C. Y., & Pillai, D. R. (2013) · doi:10.2217/ebo.13.324
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Kim, A. S., & Floch, M. H. (2014) · doi:10.2217/ebo.13.587
An Overview of the Therapeutic Aspect of Living Drugs Probiotics
Patravale, V. B., & Joshi, A. (2018) · Advances in human services and public health (AHSPH) book series · doi:10.4018/978-1-5225-3267-5.ch001
Nutritional Modulation of Critical Illness
Chan, D. L. (2014) · Elsevier eBooks · doi:10.1016/b978-1-4557-0306-7.00128-8
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Nayak, C. (2013)
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Silvestre, M. P. (2007)
Tenore, S. D. B. (2019) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.5.2019.tde-29102019-104931
Kerna, N. A. (2018) · SM Preventive Medicine and Public Health · doi:10.36876/smpmph.1021
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Desland, F. A., Christiansen, L., Rahman, M., Khan, K., Potts, A. H., González, C. F., & Lorca, G. L. (2012) · EDIS · doi:10.32473/edis-mb005-2011
Metadata
- Authors
- Boyle, R. J., Robins-Browne, R. M., & Tang, M. L.
- Affiliations
- Royal Children's Hospital (AU)
- Corresponding author
- Tang, Mimi LK
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2006-06
- Volume
- 83
- Issue
- 6
- Pages
- 1256-1264
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2170210827
- Cited by
- 776
- References
- 75
- Citations by year
- 2026: 21 · 2025: 38 · 2024: 37 · 2023: 46 · 2022: 32 · 2021: 48 · 2020: 39 · 2019: 36 · 2018: 32 · 2017: 45 · 2016: 40 · 2015: 37 · 2014: 50 · 2013: 45 · 2012: 52
- FWCI
- 4.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Keywords
- probiotics, probiotic safety, preterm infants, immunodeficiency, probiotic supplements
- MeSH terms
- Adult, Aged, Aged, 80 and over, Bifidobacterium, Child, Child, Preschool, Diarrhea, Female, Gastrointestinal Diseases, Humans, Infant, Infant, Newborn, Lactobacillus, Male, Middle Aged, Fungemia, Sepsis, Probiotics
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