Recommendations for probiotic use--2008.
Recommendations for the clinical use of probiotics were published after a Yale University Workshop in 2005. A similar workshop was held in 2007, and the recommendations were updated and extended into other areas. The recommendations are graded into an "A," "B," "C" or no category based on the expert's opinion and review by the workshop participants. An "A" recommendation is made for acute childhood diarrhea, prevention of antibiotic-associated diarrhea, preventing and maintaining remission in pouchitis, and in an immune response for the treatment and prevention of atopic eczema associated with cow's milk allergy. The group maintained several "B" recommendations in other areas of treating inflammatory bowel disease and irritable bowel syndrome. Although there are significant studies in the "B" group, most "B" recommendations did not reach an "A" level because of some negative studies or a limited number of studies. Many reports in the "C" recommendations were significant but fell short of receiving stronger ratings because of the size of reported patient studies, and also the factors that limited categories to the "B" rating.
Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT 06520-8019, USA. martin.floch@yale.edu
Martin H
MH
Floch
W Allan
WA
Walker
Stefano
S
Guandalini
Patricia
P
Hibberd
Sherwood
S
Gorbach
Christina
C
Surawicz
Mary Ellen
ME
Sanders
Guadalupe
G
Garcia-Tsao
Eamonn M M
EM
Quigley
Erika
E
Isolauri
Richard N
RN
Fedorak
Levinus A
LA
Dieleman
D000328:Adult; D002648:Child; D003967:Diarrhea / Q000209:etiology / Q000382:microbiology / Q000628:therapy; D005767:Gastrointestinal Diseases / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy; D043183:Irritable Bowel Syndrome / Q000628:therapy; D019449:Pouchitis / Q000628:therapy; D017410:Practice Guidelines as Topic; D019936:Probiotics / Q000627:therapeutic use*; D012074:Remission Induction / Q000379:methods