Table II.
Summary of published trials evaluating probiotics and synbiotics.
| Publication Year | Study Center | Product | Control | Target | Patient | Patients Enrolled | Results | Clinical Trial | Resistance Testing | Citation |
|---|---|---|---|---|---|---|---|---|---|---|
| Probiotics | ||||||||||
| 2000 | Sweden | Enterococcus faecium | Placebo | VRE | Adults | 40 | ND | Culture based | 29 | |
| 2004 | Sweden | Lactobacillus paracasei | Placebo | MDR enterics | Adults | 36 | ND | Culture based | 30 | |
| 2006 | Germany | Bifidobacterium lactis Bb12 | Placebo | MDR enterics | Preterm infants | 69 | ND | Culture based | 31 | |
| 2007 | Australia | Lactobacillus rhamnosus GG | Placebo | VRE | Adults | 27 | + | Culture based | 32 | |
| 2010 | France | L. rhamnosus Lcr35 | Placebo | VRE | Adults | 9 | ND | NCT00437580 | Culture based | 33 |
| 2010 | The Netherlands | Multiple strains | SOC | ARE, VRE | Adults | 436 | ND | Culture and Genotype | 34 | |
| 2011 | New Zealand | Escherichia coli strain Nissle 1917 | Placebo | MDR E coli | Adults | 69 | ND | Culture based | 35 | |
| 2011 | Poland | L. rhamnosus GG | Placebo | VRE | Pediatric | 61 | + | Culture based | 36 | |
| 2014 | United States | Lactobacillus acidophilus and B lactis | Placebo | ESBL organisms | Adults | 80 | ND | PCR | 37 | |
| 2014 | United States | L rhamnosus HN001 | Placebo | MRSA, VRE | Adults | 48 | ND* | NCT01112995 | Culture based | 38 |
| 2014 | China | Multiple strains | Placebo | ESBL | Preterm infants | 257 | + | Culture based | 39 | |
| 2015 | United States | L rhamnosus GG | Placebo | VRE | Adults | 11 | ND | NCT00756262 | Culture based | 40 |
| 2015 | Thailand | Lactobacillus casei | SOC | MDRO Airway | Adults | 150 | ND* | Culture based | 41 | |
| 2015 | United States | L rhamnosus GG | SOC | MDRO | Adults | 70 | ND | Culture based | 42 | |
| 2016 | United States | VSL#3 | Placebo | VRE | Adults | 50 | ND | NCT00933556 | Culture based | 43 |
| 2018 | United States | L rhamnosus HN001 | Placebo | MRSA, MSSA | Adults | 113 | ND | NCT01321606 | PCR | 44 |
| 2018 | Norway | L acidophilus | SOC | MDRO | Preterm Infants | 76 | ND | NCT02197468 | DNA extraction | 45 |
| 2019 | Iran | Multiple strains | SOC | MDRO | Adults | 120 | ND* | Culture based | 46 | |
| 2019 | Denmark | L rhamnosus GG | SOC | ESBL-E, CPE | Adults | 61 | ND | Culture based | 47 | |
| 2019 | Sweden | Viomixx | SOC | ESBL-E | Adults | 80 | ND | NCT03860415 | Culture based | 48 |
| 2020 | Turkey | L rhamnosus GG | SOC | VRE | Newborn | 45 | + | Culture based | 49 | |
| Synbiotics | ||||||||||
| 2014 | Spain | SOC | MDRO | Adults | 89 | ND | Culture based | 50 | ||
| 2016 | Brazil | Placebo | MDR enterics | 116 | ND | Culture based | 51 |
= statistically significant reduction in drug-resistant organism of interest in treatment group; ARE = ampicillin-resistant Enterococcus faecium; CPE = carbapenemas-producing Enterobacteriaceae; ESBL = extended-spectrum beta-lactamase; ESBL-E = extended-spectrum beta-lactamase Escherichia coli; MDR = multidrug-resistant; MDRO = multidrug resistant organism; MRSA = methicillin-resistant Staphylococcus aureus; ND= no difference; PCR = polymerase chain reaction; SOC = standard of care; VRE = vancomycin-resistant Enterococcus.
Trend toward decreased colonization with drug-resistant pathogens in treatment groups; not significantly different between groups.