Cited by 367Probiotics and Fermented FoodsGut microbiota and healthComplementary and Alternative Medicine Studies

The DOI matches its Crossref record; 117 of the 117 references it cites were found in a registry or an index.

A systematic review of the safety of probiotics

Didari, Tina, Solki, Sara, Mozaffari, Shilan, Nikfar, Shekoufeh, Abdollahi, Mohammad·2014·Expert Opinion on Drug Safety

DOI 10.1517/14740338.2014.872627

Open this paper in CoChat — free account

Abstract

INTRODUCTION: There is growing evidence on the use of probiotics in various diseases, especially in gastrointestinal (GI) diseases. Although probiotics have been found helpful in many illnesses, they do not always seem to be safe. Through interference with commensal microflora, they can result in opportunistic performances in the host due to bacterimia and fungemia. Since considerable numbers of consumers use probiotic products worldwide, assurance of safety of these products is necessary. AREAS COVERED: This review evaluates all the existing information about the safety of probiotics in humans and animal models up to May 2013. In all eligible published studies in which adverse effects and tolerability of probiotics were investigated and reported, no language limitations were applied. The main key search terms were 'probiotics,' 'safety,' 'side effects,' 'clinical trial' and 'adverse effects.' The vast majority of trials investigated Bifidobacterium (B) and Lactobacillus (L) species. EXPERT OPINION: The main observed adverse effects of probiotics were sepsis, fungemia and GI ischemia. Generally, critically ill patients in intensive care units, critically sick infants, postoperative and hospitalized patients and patients with immune-compromised complexity were the most at-risk populations. While the overwhelming existing evidence suggests that probiotics are safe, complete consideration of risk-benefit ratio before prescribing is recommended.

Integrity signals

Registry

Crossref · 10.1517/14740338.2014.872627

Cites

117 of 117 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Diversity of the Human Intestinal Microbial Flora
Eckburg, P. B., Bik, E. M., Bernstein, C. N., Purdom, E., Dethlefsen, L., Sargent, M., Gill, S. R., Nelson, K. E., & Relman, D. A. (2005) · Science · doi:10.1126/science.1110591 · Cited by 7,913
Bifidobacteria can protect from enteropathogenic infection through production of acetate
Fukuda, S., Toh, H., Hase, K., Oshima, K., Nakanishi, Y., Yoshimura, K., Tobe, T., Clarke, J. M., Topping, D. L., Suzuki, T., et al. (2011) · Nature · doi:10.1038/nature09646 · Cited by 2,387
Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: A double-blind, placebo-controlled trial
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
Probiotic bacteria: safety, functional and technological properties
Saarela, M., Mogensen, G., Fondén, R., Mättö, J., & Mattila-Sandholm, T. (2000) · Journal of Biotechnology · doi:10.1016/s0168-1656(00)00375-8 · Cited by 1,202
Probiotics, Prebiotics, and Synbiotics
de Vrese, M., & Schrezenmeir, J. (2008) · Advances in biochemical engineering, biotechnology · doi:10.1007/10_2008_097 · Cited by 1,061
Yogurt as probiotic carrier food
Lourens-Hattingh, A., & Viljoen, B. C. (2001) · International Dairy Journal · doi:10.1016/s0958-6946(01)00036-x · Cited by 958
Probiotics and the gut microbiota in intestinal health and disease
Gareau, M. G., Sherman, P. M., & Walker, W. A. (2010) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2010.117 · Cited by 907
A Randomized Placebo-Controlled Trial of Saccharomyces boulardii in Combination With Standard Antibiotics for Clostridium difficile Disease
McFarland, L. V. (1994) · JAMA · doi:10.1001/jama.1994.03510480037031 · Cited by 862
Efficacy of an Encapsulated Probiotic Bifidobacterium infantis 35624 in Women with Irritable Bowel Syndrome
Whorwell, P. J., Altringer, L., Morel, J., Bond, Y., Charbonneau, D., O'Mahony, L., Kiely, B., Shanahan, F., & Quigley, E. M. M. (2006) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2006.00734.x · Cited by 799
Enterococci as probiotics and their implications in food safety
Franz, C. M. A. P., Huch, M., Abriouel, H., Holzapfel, W. H., & Gálvez, A. (2011) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2011.08.014 · Cited by 795

Show all 117 references

Research works printed but not linked: 7

Ghasemi-Niri S, 2011, J Physiol Pharmacol, 62, 341
Luedtke SA, 2012, J Pediatr Pharmacol Ther, 17, 308
Bonsante F, 2013, Am J Perinatol, 30, 41
Besselink M, 2008, Ned Tijdschr Geneeskd, 152, 685
Boyle R, 2009, Clin Exp Immunol, 39, 1117
Mihatsch WA, 2004, Pediatr Res, 55, 448
Zunic P, 1991, Therapie, 46, 498

Sorted by citations

Items 201–300 of 366

Heat-killed Limosilactobacillus reuteri ATCC PTA 6475 prevents bone loss in ovariectomized mice: A preliminary study
Ribeiro, J. L., Santos, T. A., Garcia, M. T., CARVALHO, B. F. D. C., Esteves, J., Moraes, R. M., & Anbinder, A. L. (2024) · PLoS ONE · doi:10.1371/journal.pone.0304358 · Cited by 10
Safety assessment of probiotic Lactiplantibacillus plantarum MCC5231 and its persistence in gastrointestinal tract
Goel, A., & Halami, P. M. (2024) · Microbial Pathogenesis · doi:10.1016/j.micpath.2024.106824 · Cited by 11
Randomized Clinical Trial to Evaluate the Effect of Probiotic Intake on Androgenic Alopecia
García-Navarro, A., Vasallo-Morillas, M. I., Navarro-Belmonte, R., Vilanova, C., Torrent, D., Kilasoniya, A., Moles, I., Gallego, E., & Ramírez-Boscá, A. (2024) · Nutrients · doi:10.3390/nu16172900 · Cited by 11
Probiotics, prebiotics, antibiotic, Chinese herbal medicine, and fecal microbiota transplantation in irritable bowel syndrome
He, Y., Xu, R., Wang, W., Zhang, J., & Hu, X. (2020) · Medicine · doi:10.1097/md.0000000000021502 · Cited by 11
Combined use of lactic-acid-producing bacteria as probiotics and rotavirus vaccine candidates expressing virus-specific proteins
Afchangi, A., Latifi, T., Jalilvand, S., Marashi, S. M., & Shoja, Z. (2021) · Archives of Virology · doi:10.1007/s00705-021-04964-9 · Cited by 11
Will intestinal flora therapy become a new target in type-2 diabetes mellitus? A review based on 13 clinical trials
Ma, X., Wang, F., Zhao, T., Wang, W., & Dai, Q. (2021) · Nutrición Hospitalaria · doi:10.20960/nh.03866 · Cited by 11
“In infants with short bowel or cardiac stenosis, bacteremia has been reported in some cases (28).”
Background
Impact of probiotic intake on the glycemic control, lipid profile and inflammatory markers among patients with type 2 diabetes mellitus
Ismail, A., Darwish, O. A., Tayel, D. I., Elneily, D., & Elshaarawy, G. (2021) · Clinical Diabetology · doi:10.5603/dk.a2021.0037 · Cited by 11
“Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host [23].”
Background
Effectiveness of probiotics in infantile colic: A rapid review
Karkhaneh, M., Fraser, L., Jou, H., & Vohra, S. (2020) · Paediatrics & Child Health · doi:10.1093/pch/pxz007 · Cited by 10
Composition of the maternal gastrointestinal microbiome as a predictor of neonatal birth weight
Dreisbach, C., Prescott, S. M., Siega‐Riz, A. M., McCulloch, J. A., Habermeyer, L., Dudley, D., Trinchieri, G., Kelsey, C. M., & Alhusen, J. L. (2023) · Pediatric Research · doi:10.1038/s41390-023-02584-4 · Cited by 10
“The majority of probiotics used in published clinical trials include bacterium strains such as Bifidobacterium and Lactobacillus, which are known to have an impact on glucose metabolism and obesity.(50) While probiotic administration has been deemed safe in pregnancy by a large meta-analysis of over 1500 patients,(51)…”
Background
Fabrication of a microfluidic device for probiotic drug's dosage screening: Precision Medicine for Breast Cancer Treatment
Salehi, A., Naserzadeh, P., Tarighi, P., Afjeh‐Dana, E., Akhshik, M., Jafari, A. H., Mackvandi, P., Ashtari, B., & Mozafari, M. (2023) · Translational Oncology · doi:10.1016/j.tranon.2023.101674 · Cited by 10
“Probiotic has been used as dietary supplement to improve human and animal health [17].”
Background
Risk of Bias Analysis of Systematic Reviews of Probiotics for Treatment of Irritable Bowel Syndrome
Shapiro, J. M., Bernica, J., & Hernáez, R. (2018) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2018.07.010 · Cited by 10
Bio-Preservation Potential and Antimicrobial Activity of Bacteriocin-Producing Lactic Acid Bacteria Isolated from Ethiopian Traditional Fermented Dairy Products
Amenu, D., & Bacha, K. (2024) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-024-10272-w · Cited by 9
“A conical flask containing 10 ml of the milk samples was filled with the samples, and the pH meter was used to measure the pH over the course of seven days [17].”
A Perspective on the Application of Pro-/Synbiotics in Clinical Practice
Wu, X., Chen, Y., & Huang, W. C. (2017) · Frontiers in Microbiology · doi:10.3389/fmicb.2017.00866 · Cited by 9
“Microbiologists have explained that the behavior of a microbe depends on several factors, we are ignoring the warnings (Sanders et al., 2010; Pirofski and Casadevall, 2012; Didari et al., 2014; Doron and Snydman, 2015).”
Background
Probiotics: health safety considerations
Borase, H. P., Dwivedi, M., Krishnamurthy, R., & Patil, S. V. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-823733-5.00020-9 · Cited by 10
Decolonization of asymptomatic carriage of multi-drug resistant bacteria by bacteriophages?
Bonnet, M., Eckert, C., & Tournebize, R. (2023) · Frontiers in Microbiology · doi:10.3389/fmicb.2023.1266416 · Cited by 9
“…efficacy of probiotics on the decolonization of MDR bacteria, and consideration must be given to the possible impact on the gut microbiota and its consequences, as well as the risks of infection associated with these microorganisms, particularly in immunocompromised patients (Didari et al., 2014).”
Background
How can we develop better antispasmodics for irritable bowel syndrome?
Ranjbar, S., Seyednejad, S. A., Nikfar, S., Rahimi, R., & Abdollahi, M. R. (2019) · Expert Opinion on Drug Discovery · doi:10.1080/17460441.2019.1593369 · Cited by 9
“While this potential deserves to be evaluated in the clinic, recent evidence has extremely challenged the safety and the logic behind application of probiotics [111].”
BackgroundSelf-citation
Probiotics in critically ill patients: An umbrella review
Mahmoodpoor, A., Sanaie, S., Naseri, A., & Seyedi-Sahebari, S. (2022) · Indian Journal of Critical Care Medicine · doi:10.5005/jp-journals-10071-24129 · Cited by 11
Modulation of gut microbiota by diet and probiotics: potential approaches to prevent gestational diabetes mellitus
Cruz, M. C., Azinheiro, S., & Pereira, S. G. (2023) · Gut Microbiome · doi:10.1017/gmb.2023.6 · Cited by 8
“Although proven safe and without adverse effects both for mother and offspring (Didari et al., 2014), additional studies need to elucidate the modification not only in the mother ’ s metabolism and gut microbiome but also in the offspring.”
Background
Chitosan based ecofriendly nanoencapsulation formulation of Clitoria ternatea extract coated bacterial probiotic strain Lactobacillus acidophilus : a sustainable approach to improve probiotic functionality, stability, and tolerance
Lavanya, M., & Namasivayam, S. K. R. (2026) · Sustainable Food Technology · doi:10.1039/d5fb00833f · Cited by 8
Probiotics and Periodontal Diseases
Morales, A., Bravo, J., Bedoya, J., & Gamonal, J. A. (2017) · InTech eBooks · doi:10.5772/intechopen.68814 · Cited by 8
“They are considered safe for human health [8].”
Background
[Microbioma, salud y enfermedad: probióticos, prebióticos y simbióticos].
Gómez, A. N. (2019) · PubMed Central · Cited by 8
Probiotic Strains Isolated from an Olympic Woman’s Weightlifting Gold Medalist Increase Weight Loss and Exercise Performance in a Mouse Model
Lin, W., Kuo, Y., Lin, J., Lin, C.-H., Chen, J., Tsai, S., Lee, M., Hsu, Y.-J., Huang, C., Tsou, Y., et al. (2022) · Nutrients · doi:10.3390/nu14061270 · Cited by 8
“Moreover, probiotics are generally considered to be a safe dietary supplement [7] that can facilitate weight loss, reverse microbial dysbiosis-induced obesity, and improve gut integrity [8,9].”
Background
Uso de aditivos equilibradores de microbiota na alimentação de aves comerciais: Revisão
da Silva, D. A., Rabello, C. B.-V., dos Santos, M. J. B., Nascimento, J. C. D. S., Ribeiro, A. G., Macambira, G. M., Oliveira, H. S. D. H., dos Santos, A. C. F., da Silva, L. A. L., Mota, M. A. A., et al. (2021) · Research Society and Development · doi:10.33448/rsd-v10i7.16633 · Cited by 8
Functional fermented dairy products: a review of mechanisms, health potential, and technological challenges
Arslan, B. N., Döndaş, N. Y., Koçhan, S., Bulut, S. D., Tamer, M. A., Çelebioğlu, H. U., Bodur, M., Ağagündüz, D., Tabanelli, G., Barbieri, F., et al. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1779688 · Cited by 11
“Fermented dairy products containing probiotics can generally be safely consumed by healthy individuals; however, in critically ill, postoperative, or immunocompromised patients, caution is advised due to potential side effects (52, 53).”
ProbResist: a database for drug-resistant probiotic bacteria
Dou, W., Abdalla, H. B., Chen, X., Sun, C., Chen, X., Tian, Q., Wang, J., Zhou, W. J., Chi, W., Zhou, X., et al. (2022) · Database · doi:10.1093/database/baac064 · Cited by 7
Effects of probiotics on blood glucose, biomarkers of inflammation and oxidative stress in pregnant women with gestational diabetes mellitus: A meta-analysis of randomized controlled trials
Chen, Y., Yue, R., Zhang, B., Li, Z., Shui, J., & Huang, X. (2020) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2019.05.019 · Cited by 7
The Role of Diet and Supplements in the Prevention and Progression of COVID-19: Current Knowledge and Open Issues
Rossi, R. E., Chen, J., & Caplin, M. E. (2022) · Preventive Nutrition and Food Science · doi:10.3746/pnf.2022.27.2.137 · Cited by 8
“eubiosis to avoid virus entry into gut cells (Didari et al., 2014).”
Background
Probiotics for Trauma Patients: Should We Be Taking a Precautionary Approach?
Vitko, H. A., Sekula, L. K., & Schreiber, M. A. (2016) · Journal of Trauma Nursing · doi:10.1097/jtn.0000000000000263 · Cited by 7
Bifidobacteria as Probiotic Organisms: An Introduction
Quigley, E. M. M. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-804024-9.00012-4 · Cited by 7
Review On Probiotics Potentials, Nutritional Composition Of Bambara Nut (Vigna Subterranea (L.) -An Underutilized LegumE
Nwinyi, O. C., & Umane, P. O. (2019) · IOP Conference Series Earth and Environmental Science · doi:10.1088/1755-1315/331/1/012057 · Cited by 7
“Nwinyi, Obinna C*1,. Umane, Phoebe O1 1Department of Biological Sciences (Microbiology unit), Covenant University, Km 10 Idiroko Road, Canaan Land, PMB 1023 Ota, Ogun State, Nigeria.”
BackgroundInfluential
Evaluation of skin cancer prevention properties of probiotics
Torabi, S., Nahidi, Y., Ghasemi, S. Z., Reihani, A., Samadi, A., Ramezanghorbani, N., Nazari, E., & Davoudi, S. (2025) · Genes & Nutrition · doi:10.1186/s12263-025-00770-z · Cited by 10
Exploring the Multitude: A Review on Different Categorization of Probiotics
Karukuvelraja, R., & Saranya, N. (2025) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-025-10601-7 · Cited by 7
Microbiota–Host Interactions: Exploring Their Dynamics and Contributions to Human Diseases
Chin, S. W., Low, Z. Y., Tan, W. Q., & Azman, A. S. (2025) · MicrobiologyOpen · doi:10.1002/mbo3.70043 · Cited by 6
“…may not be suitable for critically ill patients that would otherwise increase opportunistic infection, and the latter brings concerns, especially in the increase of mentioned fermentable colonic bacteria, such as Ruminococcus in IBS, aggravating abdominal pain and gas bloating (Didari et al. 2014).”
Gut microbiota, inflammatory proteins and COVID-19: a Mendelian randomisation study
Chen, Y., & Chen, C. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1406291 · Cited by 6
Behavioral transcriptomic effects of triploidy and probiotic therapy (Bifidobacterium, Lactobacillus, and Lactococcus mixture) on juvenile Chinook salmon (Oncorhynchus tshawytscha)
Frank, C. E., Sadeghi, J., Heath, D. D., & Semeniuk, C. A. D. (2024) · Genes Brain & Behavior · doi:10.1111/gbb.12898 · Cited by 6
Nutrients and Nutraceuticals in Aging
Hodjat, M., Khalid, M., Asghari, M., Atri, S., Rahimifard, M., Nejad, S. M., & Baeeri, M. (2020) · Springer eBooks · doi:10.1007/978-981-15-3552-9_5 · Cited by 6
Prebióticos e probióticos na saúde e no tratamento de doenças intestinais: uma revisão integrativa
Marques, C. G., da Cruz, E. M. R. M., Bezerra, V. M., Costa, J. T. G., Lira, S. M., Holanda, M. O., da Silva, J. Y. G., Canabrava, N. D. V., da Silva, B. B., & Guedes, M. I. F. (2020) · Research Society and Development · doi:10.33448/rsd-v9i10.9071 · Cited by 7
Mitigation of Foodborne Illnesses by Probiotics
Ryan, V., & Bhunia, A. K. (2017) · Springer eBooks · doi:10.1007/978-3-319-56836-2_21 · Cited by 6
Effectiveness of probiotics in the management of inflammatory arthritis: a systematic review protocol
Lowe, J. R., Briggs, A. M., Whittle, S., Hoon, E. A., & Stephenson, M. (2018) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003692 · Cited by 6
Importance of Probiotics in Human Health
Banerjee, D., Jain, T., Bose, S., & Bhosale, V. V. (2018) · Springer eBooks · doi:10.1007/978-981-13-1123-9_23 · Cited by 7
Komagataella pastoris KM71H Attenuates Cognitive Deficits and Depressive-Like Behavior by the TLR4/NF-κB Signaling Pathway in an Aβ1-40-Induced AD-Like Mouse Model
Birmann, P. T., Zugno, G. P., Sinott, A., Rodrigues, R. R., Conceição, F. R., Sousa, F. S. S., Collares, T. V., Seixas, F. K., & Savegnago, L. (2025) · Molecular Neurobiology · doi:10.1007/s12035-025-05267-9 · Cited by 5
“However, preclinical and clinical research has focused primarily on bacterial strains (e.g., Lactobacillus ), and only a handful of studies have covered yeast [2].”
Administration of Lacticaseibacillus casei CSL3 in Swiss Mice with Immunosuppression Induced by Cyclophosphamide: Effects on Immunological, Biochemical, Oxidative Stress, and Histological Parameters
Massaut, K. B., Vitola, H. R. S., Gonçalves, V. S., Leite, F. P. L., Jardim, R. D., Moreira, Â. N., da Silva, W. P., & Fiorentini, Â. M. (2024) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-024-10362-9 · Cited by 5
“…and regulating the composition of the intestinal microbiota has been reported by researchers as an essential mechanism of action in modulating host health in numerous clinical situations, emerging as a complement in the development and adoption of new strategies of health promotion [8, 9, 56–59].”
The differing roles of lactobacilli in critical illness
Haak, B. W., & Wiersinga, W. J. (2019) · Nature Medicine · doi:10.1038/s41591-019-0623-z · Cited by 6
Bezpieczeństwo stosowania probiotyków przez ludzi
Sionek, B., & Kołożyn‐Krajewska, D. (2019) · Zywnosc-nauka Technologia Jakosc · doi:10.15193/zntj/2019/120/293 · Cited by 5
Use of Prebiotics for Addressing Gut Dysbiosis and Achieving Healthy Gut–Brain Axis
Lasrado, L. D., & Rai, A. K. (2022) · Springer eBooks · doi:10.1007/978-981-16-8444-9_11 · Cited by 6
Microencapsulation: A Prospective to Protect Probiotics
Zam, W. (2020) · Current Nutrition & Food Science · doi:10.2174/1573401315666190712222623 · Cited by 5
Probiotics: A Promising Microbial Functional Food with Diverse Health Benefits
Srivastav, H., Kumar, A., Bhargawa, P. K., Vishnoi, N., & Kumar, R. (2026) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-025-10894-8 · Cited by 4
“It was also concluded that the immune-compromised and post-surgical patients were mostly at risk [ 91].”
Gut microbiota and sepsis: mechanisms, clinical correlations, and therapeutic prospects
Yu, J., & Liu, X. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1793041 · Cited by 4
“This suggests that the “one-size-fits-all” intervention of traditional probiotics has limited clinical benefits in the complex environment of critical care (175).”
Dynamic Concerns of Protein Ice-Cream: An Analysis
Shafique, B., Mahmood, S., Alam, M. Q., & Saeed, W. (2019) · Acta Scientifci Nutritional Health · doi:10.31080/asnh.2019.03.0490 · Cited by 7
Enhancement of cell proliferation and motility of mammalian cells grown in co-culture with Pichia pastoris expressing recombinant human FGF-2
Le, H. H. M., Vang, D., Amer, N., Vue, T. Y., Yee, C., Kaou, H., Harrison, J. S., Xiao, N., Cereghino, J. L., Lin‐Cereghino, G. P., et al. (2020) · Protein Expression and Purification · doi:10.1016/j.pep.2020.105724 · Cited by 4
Improved functional properties of the potential probiotic Lacticaseibacillus paracasei ItalPN16 growing in cheese whey
Pinilla, C. M. B., Brandelli, A., Galland, F., Spadoti, L. M., & Alves, A. T. S. E. (2023) · Letters in Applied Microbiology · doi:10.1093/lambio/ovad075 · Cited by 4
Use of Autochthonous Lactic Acid Bacteria as Probiotic Additives for Muscovy Ducks in Housing
Maquiné, L. D. C., Guimarães, C. C., Santos, A. N. D. A., de Oliveira, A. T., Rufino, J. P. F., da Silva, J. L., Chaves, F. A. D. L., Mendonça, M. A. D. F., Neto, P. D. Q. C., & Pereira, J. O. (2024) · Brazilian Journal of Poultry Science · doi:10.1590/1806-9061-2024-1944 · Cited by 4
Effectiveness Of Probiotics In Irritable Bowel Syndrome: A Systematic Review With Meta-Analysis
Nikfar, S., Mozafari, S., Didari, T., & Abdollahi, M. R. (2014) · Value in Health · doi:10.1016/j.jval.2014.08.799 · Cited by 3
Self-citation
Role of Microbes in Sustainable Food Preservation
Öztürk, H. İ., & Ozturkoglu‐Budak, S. (2023) · Springer eBooks · doi:10.1007/978-981-99-4784-3_3 · Cited by 4
Fermentation of a mango beverage with Lactiplantibacillus plantarum LP01: from bench to semi-industrial scale
Orrego, D., Giraldo, N. D., Criales, S., & Klotz-Ceberio, B. (2025) · CyTA - Journal of Food · doi:10.1080/19476337.2025.2541887 · Cited by 3
“Probiotics, key elements in fermented products, stand out among the most prominent bioactive components in functional foods due to their regenerative potential and positive contributions to the digestive and immune systems (Didari et al., 2014).”
A Review of Modulation of Gut Microbiota to Mitigate Gestational Diabetes: Implications for Maternal and Child Health
Mora-Janiszewska, O., Bialic, K., Faryniak-Zuzak, A., & Darmochwał-Kolarz, D. (2025) · Medical Science Monitor · doi:10.12659/msm.948897 · Cited by 3
Natural and Biological Products Therapeutic Potential in Restoring Gut Microbiome: Mechanistic Insights and Clinical Implications
Shanmukha, K. D., Pasupuleti, V., Yadav, D. K., Baviskar, S. M., Pradhan, M., Vora, L. K., & Khatri, D. K. (2025) · Probiotics and Antimicrobial Proteins · doi:10.1007/s12602-025-10796-9 · Cited by 4
“Studies focusing on probiotic adverse effects in clinical subjects discussed the incidence of Fungemia who have consumed probiotic S.boulardii presenting bacterial strains of Saccharomyces cerevisiae or Saccharomyces boulardii in their blood samples due to digestive translocation [52, 56].”
An integrated genomic and phenotypic analysis insight into the comprehensive safety assessment of the potential probiotic Lactiplantibacillus plantarum TSP05
Liu, Q., Guo, X., Zhang, J., Tang, B., Peng, D., Liu, J., Tang, J., & Jiang, X. (2026) · Food Bioscience · doi:10.1016/j.fbio.2026.108858 · Cited by 4
The impact of knowledge and attitudes on physicians', nurses' and pharmacists' recommendation of probiotics: A systematic review
Fei, Y. Y., Steen, J. P., Tutt, E., Ng, J. Y., & Dobbins, M. (2023) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2023.102272 · Cited by 3
The interplay between gut microbiome, epigenetics, and substance use disorders: from molecular to clinical perspectives
Sahebi, K., Arianejad, M., Azadi, S., Hosseinpour-Soleimani, F., Kazemi, R., Tajbakhsh, A., & Negahdaripour, M. (2025) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2025.177630 · Cited by 3
Mechanistic insights into postbiotics as therapeutic agents in type 2 diabetes management
Ebadpour, N., Faraji, N., Abavisani, M., Karav, S., & Sahebkar, A. (2025) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-025-04456-6 · Cited by 3
“High probiotic intake has been associated with gastrointestinal adverse events and shifts in microbial composition (Liu et al. 2023; Didari et al. 2014).”
Induction of EGFP expression in Pichia pastoris during co-culture with human endothelial cell line
Thor, D., Xiao, N., Yu, R., Jivan, A., & Cha, B. (2019) · Journal of Microbiological Methods · doi:10.1016/j.mimet.2019.04.006 · Cited by 3
Investigation of the potential probiotic effects of lactic acid bacteria and cell-free supernatants against important pathogens leading to wound infections
Yılmaz, Ö., & TÜRKYILMAZ, S. (2023) · Minerva Biotechnology and Biomolecular Research · doi:10.23736/s2724-542x.22.02935-2 · Cited by 3
“The most common types of microorganisms used as probiotics are lactic acid bacteria (LAB) and Bi�dobacteria, as well as certain yeasts and other bacteria [2].”
Background
Probiotics in the prevention and control of foodborne diseases in humans
Hassan, A. A., Sayed-ElAhl, R. M. H., Hamaky, A. M. E., Oraby, N. H., & Barakat, M. H. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-823733-5.00008-8 · Cited by 3
Antibacterial activity of colostrum kefir against foodborne pathogen bacteria
Windayani, N., Kurniati, T., & Rukayadi, Y. (2020) · IOP Conference Series Earth and Environmental Science · doi:10.1088/1755-1315/472/1/012019 · Cited by 3
A pharmacovigilance study on probiotic preparations based on the FDA Adverse Event Reporting System from 2005 to 2023
Wang, Y., Tan, W., Li, X., Yang, G., Wang, Y., Liao, J., Lu, A., Zhang, G., Chen, K., Yang, L., et al. (2025) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2025.1455735 · Cited by 2
“The current study concluded that probiotic AEs are more likely to occur in older adults or critically ill infants (Didari et al., 2014).”
Elucidating the role of probiotics in modulating depression pathophysiology: insights from animal models and clinical trials - a narrative review
Dong, S., Hao, F., Xue, B., Wu, S., Zhong, R., Liao, Z., Han, H., & Fang, X. (2025) · Food Science and Human Wellness · doi:10.26599/fshw.2024.9250201 · Cited by 2
The role of oral microbiota in digestive system diseases: current advances and perspectives
Li, Y., Xin, Y., Zong, W., & Li, X. (2025) · Journal of Oral Microbiology · doi:10.1080/20002297.2025.2566403 · Cited by 4
“Individuals with compromised health or impaired immune function, including critically ill patients, pediatric populations and postoperative or hospitalized individuals, are universally recognized as high-risk cohorts [168].”
Probiotics in Women's Health: Mechanisms, Benefits, and Potential Applications for Preventing Bacterial Vaginosis and Sexually Transmitted Diseases in Sexual Health Products
Nami, Y., Barghi, A., Sadeghi, M., Farhadi, T., Babaei, S., & Haghshenas, B. (2025) · Apmis · doi:10.1111/apm.70086 · Cited by 2
“Furthermore, the precise mechanisms of action for many probiotics—such as the production of antimicrobial compounds, immune modulation, or the competitive exclusion of pathogens—are not definitively established, which complicates the design of optimized clinical trials [308, 327].”
Postbiotics as eco-friendly tools: next-generation approaches to mycotoxin mitigation
Milani, P. G., Kazemi, N., Torbati, M., Soleimani, R. A., & Rad, A. H. (2026) · Systems Microbiology and Biomanufacturing · doi:10.1007/s43393-025-00429-1 · Cited by 2
“However, probiotic applications face challenges, including strain-specific virulence factors, potential disruption of gut microbiota in vulnerable populations (e.g., neonates), and inconsistent clinical outcomes due to variable colonization patterns [21, 22].”
Effect of supplementation with synbiotics in metabolic syndrome: mechanisms and clinical implications
Abenavoli, L., YOSYPENKO, K., YURCHYSHENA, Y., Savytska, M., Lazarieva, O., Shvets, Y. V., Scarlata, G. G. M., Lynchak, O. V., & Falalyeyeva, T. M. (2026) · Minerva Gastroenterology · doi:10.23736/s2724-5985.25.04054-9 · Cited by 3
Probiotic-fortified functional foods: integrating nutrient delivery and gut health benefits
Alsanie, S. A. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1815558 · Cited by 2
“Additionally, rare cases of bacteremia and fungemia have been reported in immuno-compromised patients receiving probiotic supplementation (84).”
Association between probiotic-based nutritional modulation and psychiatric disorders: Mechanistic insights and therapeutic potential
Bohra, R., Bhardwaj, K., & Rajawat, N. K. (2026) · Nutritional Psychiatry · doi:10.1016/j.nupsyc.2026.100027 · Cited by 2
Probiotics in Human Health: Current Evidence, Mechanism of Action, and Future Perspectives
Mulaw, G., Kidanemariam, G., Bara, M., & Tesfay, T. (2026) · International Journal of Microbiology · doi:10.1155/ijm/1721210 · Cited by 3
“Note: Source: [14].”
Probiotics in the prevention and treatment of nosocomial infections
Kalabalik-Hoganson, J., Slugocki, M., & Özdener-Poyraz, E. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-823733-5.00023-4 · Cited by 2
Probiyotiklerin Ötesinde Fonksiyonel Bileşen Konseptleri: Postbiyotikler ve Paraprobiyotikler
Tatar, B., & Öztürk, H. İ. (2022) · Turkish Journal of Agriculture - Food Science and Technology · doi:10.24925/turjaf.v10i9.1747-1755.5439 · Cited by 2
Determination of the Toxicity and Sensitizing effect of a Therapeutic Probiotic agent against Intestinal and Concomitant human infections
Гаврилова, Н. Н., Ратникова, И. А., САДАНОВ, А. К., ОРАЗЫМБЕТ, С. Э., ШОРАБАЕВ, Е. Ж., Baimakhanova, B. B., & Protasiuk, L. E. (2023) · Research Journal of Pharmacy and Technology · doi:10.52711/0974-360x.2023.00682 · Cited by 3
Microbiota modifications in prehabilitation – the next step towards comprehensive preparation for surgery. The scoping review
Łoniewski, I., Banasiewicz, T., Sieńko, J., Skonieczna‐Żydecka, K., & Stachowska, E. (2024) · Gastroenterology Review · doi:10.5114/pg.2024.145833 · Cited by 5
Effect of taurine supplementation on preventing ventilator-associated pneumonia in pediatrics under mechanical ventilation, a randomized controlled double-blind clinical trial
Shirzad-Yazdi, N., Shorafa, E., Abootalebi, S. N., Heidari, R., Hojabri, K., Doostfatemeh, M., Masjedi, F., Vazin, A., & Shafiekhani, M. (2025) · Frontiers in Pediatrics · doi:10.3389/fped.2024.1490247 · Cited by 2
Post-transplant diarrhea in pediatric kidney transplant recipients
McBee, M. K., & Butani, L. (2025) · Pediatric Nephrology · doi:10.1007/s00467-024-06572-6 · Cited by 2
“Further caution must be taken in patients with additional risk factors such as neutropenia or those with central lines [72].”
Gut Microbiome in Liver Transplantation: From Preoperative Status to Posttransplant Outcomes
Vimalesvaran, S., Abdulla, M. A., & Kyrana, E. (2025) · Pediatric Transplantation · doi:10.1111/petr.70128 · Cited by 2
“Some recent reviews have highlighted concerns about probiotic use in certain patient populations, particularly immunosuppressed patients [52, 53].”
Protective effect of Lactiplantibacillus plantarum LP5 in a murine model of colonisation by Campylobacter coli DSPV458
Ruiz, M. J., Sirini, N. E., Signorini, M. L., Etcheverría, A., Zbrun, M. V., Soto, L. P., Zimmermann, J. A., & Frizzo, L. S. (2021) · Beneficial Microbes · doi:10.3920/bm2021.0010 · Cited by 2
Probiotics as an Alternative Therapy for Helicobacter pylori-Associated Diseases
Vale, F. F., Vítor, J. M. B., & Oleastro, M. (2016) · Springer eBooks · doi:10.1007/978-4-431-55936-8_24 · Cited by 2
Gluten‑hydrolyzing probiotics: An emerging therapy for patients with celiac disease (Review)
Gayathri, D., & Alurappa, R. (2020) · World Academy of Sciences Journal · doi:10.3892/wasj.2020.55 · Cited by 2
“List of commonly available commercial probiotics for human consumption (110,111).”
Background
Bridging the gap between evidence-based practice and probiotic utilization among US adults: Results from a national survey
Özdener-Poyraz, A. E., Rivkin, A. M., Iwuchukwu, O. F., & Cassino, D. (2022) · American Journal of Pharmacotherapy and Pharmaceutical Sciences · doi:10.25259/ajpps_5_2022 · Cited by 2
Psychobiotics as an Emerging Category of Probiotic Products
Choudhary, S., Shanu, K., & Devi, S. (2023) · Springer eBooks · doi:10.1007/978-981-99-1463-0_19 · Cited by 3
ТРАДИЦИОННЫЕ И СОВРЕМЕННЫЕ РАСТВОРИМЫЕ ПРЕБИОТИКИ ПРИРОДНОГО ПРОИСХОЖДЕНИЯ. Публикация 1. Про- и пребиотики в традиционной медицине и современной концепции питания
Киселева, М. А., Киселева, Т. Л., & Хлебников, Е. В. (2024) · Традиционная медицина · doi:10.54296/18186173_2024_3_17 · Cited by 2
Probiotics Intake as Adjunct Therapy for Infected Health-Care with SARS COV-2
Veterini, A. S., Kurniawati, E. M., Hamzah, H., Sudarmo, S. M., Prakoeswa, C. R. S., & Tinduh, D. (2021) · Indian Journal of Forensic Medicine & Toxicology · doi:10.37506/ijfmt.v15i2.15003 · Cited by 2
“But giving probiotics in severe and critical cases needs to be evaluated more deeply (10).”
Background
Metabolic rewiring of the probiotic bacterium Lacticaseibacillus rhamnosus GG contributes to cell-wall remodeling and antimicrobials productionPreprint
Suissa, R., Olender, T., Malitsky, S., Golani, O., Turjeman, S. C., Koren, O., Meijler, M. M., & Kolodkin‐Gal, I. (2023) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2023.01.03.522566 · Cited by 2
“Probiotic strains are consumed either as fresh fermentation products or as dried 36 bacterial supplements with Lactobacillaceae and Bifidobacteria, being the two 37 widely used probiotic genera (1, 2).”
Background
Prebiotics, Probiotics and Synbiotics
Kumar, V., Rana, A., Jagtap, P., Dhewa, T., & Taneja, N. K. (2023) · Wiley eBooks · doi:10.1002/9781394229116.ch2 · Cited by 2
Implications of Probiotics and Prebiotics on Immune Functions
Pandey, K. R., & Modi, A. (2022) · Springer eBooks · doi:10.1007/978-981-16-8990-1_10 · Cited by 1
The efficacy of probiotics, prebiotics or synbiotics in scleroderma: A systematic review
Wach, A. A., Storman, D., Więckowski, K., Wojtaszek-Główka, M., Żabicka, W., Krupka, K., Abadi, A. K., Celińska‐Löwenhoff, M., & Bała, M. M. (2025) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2025.04.004 · Cited by 1
Ascertaining the claims and reality of probiotic usage as an adjuvant therapy against virus-induced respiratory tract infections
Banerjee, A., Pal, S., Das, A. K., & Dhar, P. (2025) · Food and Humanity · doi:10.1016/j.foohum.2025.100725 · Cited by 1
Role of gut microbiome in pathogenesis and treatment of diseases: Multidisciplinary experts’ opinion of the Asian Medical Experts Academy (AMEA)
Lau, R. I., Wong, M. C. S., Lau, L. H. S., Lau, A. Y. L., Mak, I. W. C., Lo, O. S., Chan, N. N., Dai, D. L. K., & Hau, K. C. (2025) · Gut Microbes Reports · doi:10.1080/29933935.2025.2558575 · Cited by 2
Microbiome and Metabolic Immune Mechanisms in Sepsis-Associated Encephalopathy
Nan, Z. (2025) · Journal of Intensive Care Medicine · doi:10.1177/08850666251385540 · Cited by 2
Abdominal compartment syndrome following chemotherapy-induced gastrointestinal mucositis: a case report
Li, T.-L., Li, M., Yang, X.-M., Wei, J., & Huang, L. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1718333 · Cited by 1
Nutraceutical Strategies for Blood Pressure Control: Mechanisms, Evidence, and Clinical Implications
Vrcelj, T., Služek, V. B., Kiš, M. F., Waisundara, V. Y., & Banjari, I. (2026) · Nutraceuticals · doi:10.3390/nutraceuticals6020036 · Cited by 1
“Despite encouraging findings, interpretation of current evidence remains limited by substantial heterogeneity in probiotic strains, dosing regimens, treatment duration, participant characteristics, and outcome assessment across studies [93].”
Rethinking probiotics: breaking the Lactobacillus - Bifidobacterium duopoly in the management of dysbiosis and allergies
Cappella, C., Redaelli, C., Balzarotti, M., Scarcia, P., Agrimi, G., & Bettiga, M. (2026) · Gut Microbes · doi:10.1080/19490976.2026.2673679 · Cited by 1
“54,55 Additional concerns include horizontal gene transfer of antimicrobial-resistance determinants and the unpredictable behavior of live microorganisms in altered host environments, particularly when administered at high doses or for prolonged periods.”
The microbiota-metabolite-immune axis in the olfactory cleft microenvironment: mechanisms and therapeutic implications for dysbiosis-driven olfactory dysfunction in chronic rhinosinusitis
Zhu, J.-X., & Huang, G. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1841979 · Cited by 1
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
“…control [15,26] Limited long-term safety data in high-risk populations Uncertainty regarding rare adverse events Prospective safety studies [145,146] Differences in regulatory requirements Variability in product evaluation and quality assessment across jurisdictions International harmonization…”

Authors: Didari, T., Solki, S., Mozaffari, S., Nikfar, S., & Abdollahi, M.
Affiliations: Islamic Azad University, Tehran (IR)
Pharmaceutical Sciences Research Center (IR)
Ministry of Health and Medical Education (IR)
ORCID: Didari, Tina
Mozaffari, Shilan
Nikfar, Shekoufeh
Abdollahi, Mohammad
Venue: Expert Opinion on Drug Safety
Publisher: Informa Healthcare
Published: 2014-01-03
Volume: 13
Issue: 2
Pages: 227-239
ISSN: 1474-0338 (ISSN-L)
1744-764X
DOI: 10.1517/14740338.2014.872627
OpenAlex: W2125631968
Cited by: 367
References: 117
Citations by year: 2026: 27 · 2025: 44 · 2024: 32 · 2023: 42 · 2022: 41 · 2021: 41 · 2020: 38 · 2019: 28 · 2018: 27 · 2017: 14 · 2016: 11 · 2015: 14 · 2014: 8
FWCI: 1.94
Type: journal article
Language: en
Open access: closed
Locations: Expert Opinion on Drug Safety (publishedVersion)
PubMed (publishedVersion)
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
Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
Keywords: probiotics, probiotic safety, adverse effects, sepsis, fungemia, gastrointestinal ischemia, Bifidobacterium, Lactobacillus, opportunistic infections, commensal microbiota, critically ill patients, immunocompromised patients, risk-benefit ratio
MeSH terms: Animals, Bifidobacterium, Humans, Lactobacillus, Safety, Probiotics, Drug-Related Side Effects and Adverse Reactions

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

A systematic review of the safety of probiotics

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cites

Cited by

Related

Metadata

Record

About these checks