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
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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“A systematic literature review of probiotic safety published in 2014 reported that “the overwhelming existing evidence suggests that probiotics are safe” for the general population, and that critically ill patients, postoperative and hospitalized patients and immunocompromised patients were the most at-risk groups wherein AEs occurred [220].”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [220]
Citations
Cites
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
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
McFarland, L. V. (1994) · JAMA · doi:10.1001/jama.1994.03510480037031 · Cited by 862
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
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
Cited by
Sorted by citations
The pros, cons, and many unknowns of probiotics
Suez, J., Zmora, N., Segal, E., & Elinav, E. (2019) · Nature Medicine · doi:10.1038/s41591-019-0439-x · Cited by 1,398
Mechanisms of action of probiotics
Plaza-Diaz, J., Ruiz-Ojeda, F. J., Gil-Campos, M., & Gil, A. (2019) · Advances in Nutrition · doi:10.1093/advances/nmy063 · Cited by 1,423
“The effects of probiotics on host health have been reported in many articles, reviews, and systematic reviews (12, 13).”
BackgroundMicroorganisms with Claimed Probiotic Properties: An Overview of Recent Literature
Fijan, S. (2014) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph110504745 · Cited by 1,059
“The most common types of microorganisms used as probiotics are lactic acid bacteria and bifidobacteria, although other bacteria and certain yeasts are also used [17].”
BackgroundProbiotics for the prevention of pediatric antibiotic-associated diarrhea
Goldenberg, J. Z., Lytvyn, L., Steurich, J., Parkin, P. C., Mahant, S., & Johnston, B. C. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004827.pub4 · Cited by 635
The gut microbiota influences anticancer immunosurveillance and general health
Routy, B., Gopalakrishnan, V., Daillère, R., Zitvogel, L., Wargo, J. A., & Kroemer, G. (2018) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-018-0006-2 · Cited by 523
Metadata
- 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)
- 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
- 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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