What is Saccharomyces (a type of fungus)?

From the Guidelines

The use of Saccharomyces boulardii as a probiotic is recommended for the prevention of Clostridioides difficile infection in adults and children on antibiotic treatment, as suggested by the AGA guidelines 1. The effectiveness of Saccharomyces boulardii as a probiotic stems from its ability to inhibit harmful bacteria, enhance immune function, and protect the intestinal lining. Some key points to consider when using Saccharomyces boulardii as a probiotic include:

• Typical doses range from 250-500 mg taken 1-4 times daily
• The use of Saccharomyces boulardii may have a beneficial effect on cessation and recurrence of diarrhea, as reported in a study with a relative risk of 1.33 and 0.59, respectively 1
• The overall certainty of evidence for the use of Saccharomyces boulardii as a probiotic is low, and further studies are needed to define its effectiveness and identify which patient populations may benefit from this intervention 1
• The use of probiotics, including Saccharomyces boulardii, should be approached with caution in certain patient populations, such as those with severe illnesses, immunocompromised patients, or patients at risk of bacteremia or fungemia 1
• Other probiotic strains, such as Lactobacillus acidophilus and Bifidobacterium bifidum, may also be effective in preventing C. difficile infection, but the evidence is less supportive 1

From the Research

Saccharomyces Boulardii Overview

• Saccharomyces boulardii is a type of yeast that has been studied for its potential to prevent and treat various types of diarrhea, including antibiotic-associated diarrhea (AAD) and acute infectious diarrhea.
• The effectiveness of S. boulardii in preventing AAD has been investigated in several studies, with mixed results 2, 3, 4, 5.

Prevention of Antibiotic-Associated Diarrhea

• A study published in 2008 found that S. boulardii did not prevent diarrhea related to amoxicillin treatment in adult outpatients 2.
• In contrast, a review of 17 studies on the use of S. boulardii in the prevention of AAD found that the yeast achieved a protective effect in 14 of the studies, with a significant reduction in the risk of developing AAD 3.
• A randomized, double-blind, placebo-controlled trial in children found that S. boulardii reduced the risk of antibiotic-associated diarrhea by 70% compared to placebo 4.
• However, a similar trial in adult hospitalized patients found that S. boulardii was not effective in preventing AAD 5.

Treatment of Acute Infectious Diarrhea

• A systematic review and meta-analysis of studies on the use of S. boulardii in the treatment of acute infectious diarrhea found that the yeast significantly reduced the duration of diarrhea and hospitalization 6.
• The review found that S. boulardii shortened the initial phase of watery stools and reduced the number of stools at days 3 and 4.

Safety and Efficacy

• S. boulardii has been found to be safe and well-tolerated in most studies, with no significant adverse effects reported 2, 4, 5.
• However, the efficacy of S. boulardii in preventing and treating diarrhea may depend on various factors, including the type and duration of antibiotic treatment, the population being studied, and the dosage and formulation of the yeast.