title: Kombucha: a systematic review of the clinical evidence.
abstract: OBJECTIVE
  Kombucha has become a popular complementary remedy. The aim of this systematic review was to critically evaluate the evidence related to its efficacy and safety.
  
  
  METHODS
  Computerised literature searches were carried out to locate all human medical investigations of kombucha regardless of study design. Data were extracted and validated by the present author and are reported in narrative form.
  
  
  RESULTS
  No clinical studies were found relating to the efficacy of this remedy. Several case reports and case series raise doubts about the safety of kombucha. They include suspected liver damage, metabolic acidosis and cutaneous anthrax infections. One fatality is on record.
  
  
  CONCLUSIONS
  On the basis of these data it was concluded that the largely undetermined benefits do not outweigh the documented risks of kombucha. It can therefore not be recommended for therapeutic use.
authors.affiliation: Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, UK. Edzard.Ernst@pms.ac.at
authors.forename: E
authors.initials: E
authors.lastname: Ernst
mesh_terms: D000091:Acetobacter / Q000378:metabolism; D001628:Beverages / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D005285:Fermentation; D006801:Humans; D015201:Meta-Analysis as Topic; D010843:Pichia / Q000378:metabolism; D012307:Risk Factors; D012449:Safety; D016896:Treatment Outcome