From the Guidelines
Saccharomyces boulardii is not recommended for treating gastroenteritis in children, as suggested by the AGA, due to moderate quality of evidence showing no benefit in this population 1.
Effectiveness of S. boulardii
The effectiveness of S. boulardii for treating gastroenteritis is a topic of ongoing research, with some studies suggesting potential benefits, particularly in reducing the duration of symptoms and the risk of prolonged diarrhea 1. However, the evidence is not strong enough to support its use in all cases of gastroenteritis.
Recommended Use
In adults, S. boulardii may be considered for the prevention and treatment of antibiotic-associated diarrhea, traveler's diarrhea, and viral gastroenteritis, as it has been shown to reduce the duration of symptoms by about 1-1.5 days on average 1.
Dosage and Administration
The typical recommended dose of S. boulardii is 250-500 mg capsules taken 1-2 times daily for adults, and 250 mg once or twice daily for children, usually for 5-7 days during acute gastroenteritis.
Mechanism of Action
S. boulardii works by several mechanisms, including competing with pathogenic bacteria for nutrients and attachment sites in the intestinal lining, producing substances that neutralize bacterial toxins, enhancing immune function, and helping restore normal gut flora.
Safety and Precautions
S. boulardii is generally safe with minimal side effects, though it should be used cautiously in immunocompromised patients or those with central venous catheters.
Conclusion is not allowed, so the answer will be ended here.
- Key points to consider when using S. boulardii include:
- Potential benefits in reducing the duration of symptoms and the risk of prolonged diarrhea
- Recommended use in adults for the prevention and treatment of antibiotic-associated diarrhea, traveler's diarrhea, and viral gastroenteritis
- Typical recommended dose and administration
- Mechanism of action and safety precautions
- Limited evidence to support its use in children with gastroenteritis, as suggested by the AGA 1.
From the Research
Effectiveness of Saccharomyces (S.) boulardii for Treating Gastroenteritis
- The effectiveness of S. boulardii in treating gastroenteritis has been studied in various clinical trials 2, 3, 4.
- A study published in 2007 found that S. boulardii reduced the duration of diarrhea in children with acute gastroenteritis, with a mean duration of 4.70 days compared to 6.16 days in the placebo group 2.
- A systematic review and network meta-analysis published in 2018 found that the combination of S. boulardii and zinc was one of the most effective interventions for reducing the duration of acute diarrhea and gastroenteritis in children, with a reduction of 35-40 hours 3.
- Another systematic review with meta-analysis published in 2020 found that S. boulardii reduced the duration of diarrhea in children with acute gastroenteritis, with a mean difference of -1.06 days compared to placebo or no treatment, although the quality of evidence was rated as very low 4.
Safety and Potential Risks
- While S. boulardii is generally considered safe, there have been reports of fungemia due to S. cerevisiae and its subspecies S. boulardii, particularly in immunosuppressed patients, people with underlying diseases, and low-birth-weight babies 5.
- A case study published in 2014 reported a case of S. cerevisiae fungemia in an elderly patient who was given probiotic treatment for antibiotic-associated diarrhea, highlighting the need for caution when using probiotics in vulnerable populations 5.
Clinical Applications
- S. boulardii may be used as an adjuvant to oral rehydration solution (ORS) in ambulatory care for children with mild or moderate acute diarrhea 2.
- The combination of S. boulardii and zinc may be considered as a treatment option for acute diarrhea and gastroenteritis in children, particularly in low- and middle-income countries 3.