Table 1.

Large Systematic Reviews (>1000 patients) of Randomized Controlled Clinical Trials That Included Probiotics for the Treatment of Specific Gastrointestinal Diseases

Indication	Patient population	N	Species	Result	Reference
Acute gastroenteritis	Adults and children with infectious diarrhea duration <14 days	1917	Lactobacillus spp.	Reduced risk of diarrhea at 3 days (RR, 0.66; 95% CI, 0.55– 0.77)	Allen et al, 200492
			Streptococcus spp.	Reduced duration by 30.48 (95% CI, 18.51– 42.46) hours
			E. faecium
			“S. boulardii”
	Children 1–60 months old with diarrhea duration <1 week	1917	Lactobacillus spp.	Reduced duration by 0.8 days (95% CI, 0.6–1.1 days)	Huang et al, 200293
			Bifidobacterium spp.
			S. thermophilus
			B. subtilis
			E. faecium
			“S. boulardii”
C. difficile-associated diarrhea or colitis	Children <18 years of age receiving antibiotic therapy for any reason	1986	Lactobacillus spp.	Per-protocol: reduced risk of AAD (RR, 0.49; 95% CI, 0.32–0.74)	Johnston et al, 200797
			Bifidobacterium spp.	Intention-to-treat: no significant benefit (RR, 0.90; 95% CI, 0.50–1.63)
			S. thermophilus
			“S. boulardii”
	Children and adults receiving antibiotics	1214	Lactobacillus spp.	Reduced risk of AAD (OR, 0.37; 95% CI, 0.26 – 0.53)	D’Souza et al, 2002100
			B. longum	Bacteria reduced risk (OR, 0.34; 95% CI, 0.19 – 0.61)
			E. Faecium	Yeast reduced risk (OR, 0.39; 95% CI, 0.25–0.62)
			“S. boulardii”
Irritable bowel syndrome	Children and adults with IBS established by Rome criteria	1011	Lactobacillus spp.	Improved clinical outcomes (RR, 1.22; 95% CI, 1.07–1.4)	Nikfar et al, 2008128
			Bifidobacterium spp.
			VSL#3
			Propionibacterium freudenreichii
	Children and adults with IBS	1404	Lactobacillus spp.	Reduced global IBS symptoms (RR, 0.77; 95% CI, 0.62–0.94)	McFarland and Dublin 2008129
			Bifidobacterium spp.	Reduced abdominal pain (RR, 0.78; 95% CI, 0.69–0.88)
			Streptococcus spp.
			VSL#3
			B. subtilis
			L. lactis
			E. coli
			P. freudenreichii
			“S. boulardii”
Necrotizing enterocolitis	Preterm infants <37 weeks and/or birth weight <2500 g	1425	Lactobacillus spp.	Reduced incidence of stage II–III	Alfaleh and Bassler 2008147
			Bifidobacterium spp.	NEC (RR, 0.32; 95% CI, 0.17–0.60)
			S. thermophilus	Reduced risk of mortality (RR, 0.43; 95% CI, 0.25–0.75)
			“S. boulardii”	No significant reduction in risk of nosocomial sepsis or number of days on total parenteral nutrition
	Preterm very low birthweight neonates <33 weeks gestation and birth weight <1500 g	1393	Lactobacillus spp.	Reduced risk of stage II–III NEC (RR, 0.36; 95% CI, 0.20–0.65)	Deshpande et al, 2007148
			Bifidobacterium spp.	Reduced risk of death (RR, 0.47; 95% CI, 0.3– 0.73)
			S. thermophilus	Reduced number of days to full feeds (RR, −2.74; 05% CI, −4.98 to −0.51)
			“S. boulardii”	No significant reduction in risk of sepsis

AAD, antibiotic-associated diarrhea; CI, confidence interval; OR, odds ratio; RR, relative risk.