Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Saccharomyces, particularly Saccharomyces boulardii, has some scientific support for use as an adjunct in the management of thrush (oral candidiasis), though the evidence is limited and not robust. The rationale is based on the probiotic properties of S. boulardii. Several laboratory and small clinical studies suggest that this yeast can inhibit the growth and adhesion of Candida albicans, the primary causative agent of thrush, through the production of specific enzymes and by modulating local immune responses. Some randomized controlled trials have evaluated S. boulardii in populations at risk for candidiasis, such as individuals on antibiotics or immunosuppressive therapy, and reported reduced rates of fungal colonization or infection when compared to controls. However, these studies often have methodological limitations, small sample sizes, and sometimes focus on gastrointestinal rather than oral candidiasis.

Current clinical guidelines do not routinely recommend Saccharomyces species as a standalone treatment for thrush, but it may be considered as an adjunct to standard antifungal therapies. The evidence base is rated as low to moderate (2/5) due to the limited number and size of studies, lack of large-scale randomized trials, and variability in outcomes. The use of S. boulardii is generally safe in immunocompetent individuals, but caution is advised in immunocompromised patients due to rare reports of fungemia. In summary, there is some scientific evidence supporting its adjunctive use, but stronger evidence is needed before it can be broadly recommended.

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