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

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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

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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.

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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

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A systematic review of the safety of probiotics

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