Probiotics - Role In Medicine

Probiotics are nonpathogenic microbes used to confer health benefits to the recipient. The derangement of normal body flora has been held responsible for causation of various disorders. Probiotics have been tried in a number of infective and noninfective disorders and found useful, primarily because of their ability to supplement the normal body flora. Their use offers various advantages over existing antimicrobial agents in being relatively cheap and safe. Various bacterial genera most commonly used in probiotic preparations are Lactobacillus, Bifidobacterium, Escherichia, Enterococcus, Bacillus and Streptococcus. Some fungal strains belonging to Saccharomyces have also been used. Probiotics have been shown to be effective in varied clinical conditions ranging from antibiotic-associated diarrhoea, infantile diarrhoea, necrotising enterocolitis, relapsing Clostridium difficile colitis, Helicobacter pylori infections, inflammatory bowel disease to cancer, female uro-genital infection and surgical infections. Lactobacillus rhamnosus strain GG has proven beneficial effects on intestinal immunity. It increases the number of IgA and other immunoglobulins secreting cells in the intestinal mucosa. It also stimulates local release of interferons. However, there are few reports of systemic fungaemia associated with their use especially, in immunocompromised and severely debilitated patients. They also carry a risk of transferring resistance to other microbes including pathogens. Probiotics are live microorganisms, so it is possible that they may result in infection in the host. The risk and morbidity of sepsis due to probiotic bacteria should be weighed against the potential for sepsis due to more pathological bacteria and the morbidity of diseases for which probiotic bacteria are being used as therapeutic agents. In conclusion, more studies are required to establish their definite place in therapeutics. This review is an attempt to discuss briefly the role of probiotics in medicine.