Use of probiotics to correct dysbiosis of normal microbiota following disease or disruptive events : a systematic review

McFarland, Lynne V

doi:10.1136/bmjopen-2014-005047

Cited by 235Probiotics and Fermented FoodsGut microbiota and healthReproductive tract infections research

Use of probiotics to correct dysbiosis of normal microbiota following disease or disruptive events : a systematic review

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McFarland, Lynne V·2014·BMJ Open

DOI 10.1136/bmjopen-2014-005047PMC PMC4156804

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Abstract

OBJECTIVE: To assess the evidence for the claim probiotics can correct dysbiosis of the normal microbiota resulting from disease or disruptive events. SETTING: Systematic review of published clinical trials of patients receiving a probiotic intervention for the prevention or treatment of various diseases. DATA SOURCES: Sources searched (1985-2013): PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL, AMED and ISI Web of Science. Three on-line clinical trial registries were searched: Cochrane Central Register of Controlled trials, MetaRegister of Controlled Trials and National Institutes of Health. REVIEW METHODS: Included studies were randomised clinical trials of probiotic interventions having microbiological assays. Studies were evaluated following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for specific probiotic strains. A standard data extraction form was used to collect the raw data. OUTCOME MEASURES: The primary outcome is the degree of microbiota correction by specific probiotic strains. Secondary outcome was the association between the degree of dysbiosis correction and clinical efficacy. RESULTS: The review of the literature found three distinct study designs: model A (restoration) assayed patients enrolled with a healthy, undisturbed microbiota and then assayed postdisruptive event and probiotic therapy; model B (alteration) assayed patients with pre-existing disrupted microbiota and then postprobiotic therapy; model C (no dysbiosis) assayed volunteers with no disruptive event prebiotic and postprobiotic. From a total of 63 trials, 83% of the probiotic products using model A restored the microbiota, 56% using model B improved the microbiota and only 21% using model C had any effect on microbiota. Clinical efficacy was more commonly associated with strains capable of restoration of the normal microbiota. CONCLUSIONS: The ability to assess the degree of dysbiosis improvement is dependent on the enrolled population and the timing of microbiological assays. The functional claim for correcting dysbiosis is poorly supported for most probiotic strains and requires further research. TRIAL REGISTRATION NUMBER: PROSPERO (CRD42014007224).

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Probiotics seem to offer some promising potential for re-establishing the microbiome following antimicrobial insult.
“and probiotics seem to offer some promising potential for re-establishing the microbiome following antimicrobial insult (Mcfarland, 2014).”
From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Mcfarland, 2014

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[52]Orrhage K Brismar B Nord CE Effects of supplements of Bifidobacterium longum and Lactobacillus acidophilus on the intestinal microbiota during administration of clindamycin. Microb Ecol Health Dis 1994; 7: 17– 25
[65]Girard-Pipau F Pompei A Schneider S Intestinal microflora, short chain and cellular fatty acids, influence of a probiotic S. boulardii. Microb Ecology Health Dis 2002; 14: 220– 7

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Authors: McFarland, L. V.
Affiliations: University of Washington (US)
Corresponding author: McFarland, Lynne V
ORCID: McFarland, Lynne V
Venue: BMJ Open
Publisher: BMJ
Published: 2014-08
Volume: 4
Issue: 8
Pages: e005047
ISSN: 2044-6055 (ISSN-L)
DOI: 10.1136/bmjopen-2014-005047
PMC: PMC4156804
OpenAlex: W1987378090
Cited by: 235
References: 118
Citations by year: 2026: 8 · 2025: 23 · 2024: 23 · 2023: 28 · 2022: 22 · 2021: 33 · 2020: 19 · 2019: 15 · 2018: 19 · 2017: 15 · 2016: 14 · 2015: 16
FWCI: 1.87
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc
Locations: BMJ Open (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Topics: Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Keywords: probiotics, dysbiosis, gut microbiota, microbiota restoration, probiotic strains, microbiological assay, disruptive events, clinical efficacy, prebiotics
MeSH terms: Disease, Humans, Severity of Illness Index, Treatment Outcome, Probiotics, Microbiota, Dysbiosis

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Use of probiotics to correct dysbiosis of normal microbiota following disease or disruptive events : a systematic review

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