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1 From the Johns Hopkins University School of Medicine, Balitmore.
In the past century the beneficial roles of non-pathogenic bacteria in the intestinal lumen were described. In the past decade there has been a dramatic increase in scientific work supporting the concept that there are clinical benefits to ingest-ing specific nonpathogenic organisms (probiotics). The potential benefits of modifying the intestinal flora composition of certain high-risk groups, eg, premature infants, travelers, and children receiving antibiotics, are emerging in the literature. Studies doc-umenting prophylactic and therapeutic benefits in acute viral gas-troenteritis and in atopic disease point not only to the potential applications, but also to the fact that the mechanisms of action of these agents may be due to their interaction with the gut as an immunologic organ. The benefits documented thus far are of varying degree and are most likely dependent on the number of agents, the dose, the dosing patterns, and the characteristics of the host and its underlying luminal microbial environment. Conse-quently, the safety and specification of a particular probiotic agent and methods of delivery to a particular population for a par-ticular purpose should be carefully documented before making broad recommendations. The cost-benefit assessment of adding probiotics to our diet for prophylactic or therapeutic purposes, as well as better regulation of these agents as commercial products, is also needed.
Key Words: Probiotics • probiotic agents • intestinal flora • lactose malabsorption • antibiotics • diarrhea • traveler's diarrhea • antibiotic-associated diarrhea • rotavirus • atopic disease • lactobacilli • bifidobacteria
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