Appropriate Dosage of Bacillus clausii Probiotic Spores
The recommended dosage of Bacillus clausii probiotic spores is 4 billion CFU/day for children and 6 billion CFU/day for adolescents and adults for up to 14 days. 1
Dosage Recommendations by Age Group
Children
- 4 billion spores per day (typically administered as 2 billion spores twice daily) 1, 2
- For infants and children with acute diarrhea: 2 billion spores per 5 mL bottle, administered twice daily (morning and evening) for 5 days 3
- For persistent diarrhea in children: Higher dosages of 4-6 ampoules daily (each containing 2 billion CFU/5 mL) have shown significant efficacy 4
Adolescents and Adults
- 6 billion spores per day (typically administered as 3 billion spores twice daily) 1
- Duration of treatment typically ranges from 5-14 days depending on the condition being treated 1, 5
Dosage by Clinical Indication
Antibiotic-Associated Diarrhea (AAD) Prevention
- Adults: 6 billion CFU/day for the duration of antibiotic treatment and up to 7 days after completion 1
- Children: 4 billion CFU/day during antibiotic treatment and up to 7 days after completion 1
Acute Diarrhea Treatment
- Children aged 6 months to 5 years: One mini bottle of B. clausii (2 billion spores per 5 mL) twice daily for 5 days 3
- For community-acquired diarrhea in children: 1-2 vials of B. clausii (each containing 2 billion spores per 5 mL) daily for 5-7 days 5
Persistent Diarrhea Treatment
- Children: 4-6 ampoules daily (each containing 2 billion CFU/5 mL), which has shown to reduce recovery time by approximately 2 days compared to standard treatment 4
Irritable Bowel Syndrome (IBS)
- Children aged 6-17 years: Total dose of 4 billion spores/day administered once daily for 8 weeks 2
Administration Guidelines
- B. clausii spores can be administered orally via suspension, mini bottles, or capsules 1, 3, 5
- For infants and young children, the contents can be mixed with water, milk, or juice at room temperature 5
- Administration should ideally be between meals to maximize probiotic survival and colonization 1
- For patients with feeding tubes, B. clausii can be administered through nasogastric or nasojejunal tubes 6
Clinical Considerations
- B. clausii is resistant to most commonly used antibiotics, making it suitable for concurrent administration with antibiotic therapy 1
- The probiotic shows good tolerability with a very low adverse event rate (0.09%) 5
- Reported adverse events are generally mild to moderate and may include vomiting, erythematous rashes, and stool color changes 5
- No significant safety concerns have been reported in clinical trials 1, 2, 3, 4, 5
Special Populations
- Critically ill patients: While specific B. clausii dosing is not established for this population, other probiotics have been studied in ICU settings with various dosing regimens 6
- Pregnant women: No specific contraindications, but limited data exists on use during pregnancy 1
Remember that B. clausii appears to be most effective when started early in the course of treatment, particularly for diarrheal conditions 4, 5.