Lactobacillus

Lactobacillus Brand Names

BioGaia | Culturelle | Culturelle Kids | Florajen | Floranex Granules | Mega Probiotic | Probiotic | Probiotic Acidophilus

What is Lactobacillus

Lactobacillus is an acid-producing probiotic bacterium. Four species are used clinically, Lactobacillus acidophilus, L. bulgaricus, L. reuteri, and L. rhamnosus GG. Lactobacillus acidophilus is a normal bowel inhabitant and is the most commonly used Lactobacillus species in the United States. 

Lactobacillus bulgaricus is added to some commercially available products but is not a normal inhabitant of the bowel.

Combination products containing L. acidophilus and L. bulgaricus are available. Lactobacillus rhamnosus GG (Culturelle®) is probably the most studied of the Lactobacillus species and is also not a normal inhabitant of the bowel. It is resistant to glycopeptide antibiotics such as vancomycin and teicoplanin. 

Lactobacillus rhamnosus GG has been shown to survive in gastric and bile secretions, effectively colonize the GI tract, and bind to epithelial cells. Generally, Lactobacillus preparations are used to reestablish the normal physiologic and bacterial flora of the intestinal tract.

They are administered orally in the treatment of uncomplicated diarrhea, particularly that caused by modification of the intestinal flora by antibiotics. 

Lactobacillus preparations have shown efficacy in treating and preventing antibiotic-associated diarrhea, however, they appear to be ineffective in preventing traveler’s diarrhea.

Literature reviews report that Lactobacillus rhamnosus GG preparations provide significant benefits in treating children with acute rotavirus gastroenteritis. 

Lactobacillus acidophilus has also been used in patients with ulcerative colitis, irritable colon, diverticulitis, colostomies with either diarrhea or constipation, functional constipation, mucous or spastic diarrhea, and diarrhea following amebiasis, however, data supporting efficacy in these conditions are lacking.

Although not FDA-approved drug products and regulated as dietary supplements, Lactobacillus products have been in clinical use for decades.

Indications

1. atopic dermatitis
2. diarrhea
3. infectious diarrhea
4. nutritional supplementation

For nutritional supplementation to support intestinal health and support normal physiologic bacterial flora of the intestinal tract or for the treatment of uncomplicated diarrhea, including antibiotic-associated diarrhea† and infectious diarrhea

Side Effects

1. constipation
2. flatulence
3. hiccups
4. infection
5. nausea
6. rash

Monitoring Parameters

• laboratory monitoring not necessary

Contraindications

• acquired immunodeficiency syndrome (AIDS)
• breast-feeding
• children
• immunosuppression
• infants
• lactase deficiency
• milk protein hypersensitivity
• neonates
• pregnancy
• prosthetic heart valves
• valvular heart disease

Interactions

• Ethanol

Ethanol: (Moderate) Excessive ethanol (e.g., alcoholism) may result in increased urinary excretion of magnesium. Avoid high intakes of ethanol while taking magnesium salts.