Lactobacillus brevis (Levilactobacillus brevis): A Comprehensive Reference
1. Identity, Taxonomy, and Nomenclature
Current accepted name: Levilactobacillus brevis (Orla-Jensen 1919) Zheng et al. 2020. Former name: Lactobacillus brevis, which remains widely used in the scientific and commercial literature. The organism was first described as Betabacterium breve by S. Orla-Jensen in 1919. It was later reclassified to the Lactobacillus designation, and after further reclassification of the Lactobacillus genus in 2020, became part of the Levilactobacillus genus, where it remains. The International Journal of Systematic and Evolutionary Microbiology (IJSEM) published this new classification on 15 April 2020, scattering species of the Lactobacillaceae family under Lactobacillus, Paralactobacillus, Pediococcus, and 23 novel genera, based on several genetic approaches and markers including average nucleotide identity, average amino acid identity, core-gene amino acid identity, core genome phylogeny, and metabolic or ecological criteria.
The genus name Levilactobacillus derives from the ability of member species to act as "leaveners," referring to their widespread use as starter cultures for bread and other fermented foods. The specific epithet brevis is the Latin word for "short."
L. brevis is the type species of the genus Levilactobacillus (previously the L. brevis group), which comprises 24 species. The type strain is ATCC 14869, and the genome was sequenced for strain ATCC 367, which has a size of 2.34 Mb.
Morphology and Microbiological Characteristics
Levilactobacillus brevis is a Gram-positive, rod-shaped species of lactic acid bacteria which is heterofermentative, creating CO₂, lactic acid, and acetic acid or ethanol during fermentation. It is a non-spore-forming, microaerophilic, obligate heterofermentative bacterium. As a heterofermentative species, it utilizes hexoses by the 6-phosphogluconate pathway, producing lactic acid, CO₂, and ethanol or acetic acid in equimolar amounts.
Although the sequenced genome of L. brevis is relatively small, the lactic acid bacteria can encode a multitude of different transporters to fulfill the needs of both prototrophic and auxotrophic strains. Based on the comparative analysis of 16S rRNA sequences, Lb. brevis strains are uniquely positioned among the lactobacilli without inclusion in the seven specific groups.
Natural Habitat and Ecological Sources
Lactobacillus brevis is a microaerophilic, obligately heterofermentative lactic acid bacterium isolated from many different environments. This microorganism is present in many different environments, such as sauerkraut, sourdough, silage, milk, cheese, the mouth, and the intestinal tract of humans and animals, and is involved in the production of a wide spectrum of fermented products. Strains of Lb. brevis, which was previously known as Betabacterium breve, are isolated from dairy products, silage, and animals.
L. brevis is frequently found on plant material, in the human gastrointestinal tract, and is often found in fermented foods and feed such as milk, sourdoughs, cheeses, sauerkraut, olives, and silage. Levilactobacillus brevis is primarily associated with sourdough and silage fermentations, but it has also been found among the non-starter lactic acid bacteria (NSLAB) population of Cheddar cheese and many artisanal dairy products.
2. Traditional and Historical Use
L. brevis has not been traditionally identified or isolated as a discrete ingredient; rather, it has been consumed for millennia as an uncharacterized component of a wide variety of traditionally fermented foods across multiple civilizations. Its formal microbiological characterization is modern, but its role in traditional food practices is ancient.
Europe: Sauerkraut and Fermented Vegetables
Lactobacillus brevis is naturally found in sauerkraut, and traditionally produced sauerkraut has long been known to be a good source of lactic acid bacteria. During sauerkraut preparation, Lactobacillus brevis and other lactic acid bacteria, such as Lactococcus and Leuconostoc species, help to ferment cabbage. During this process, the bacteria break down sugars in the cabbage, producing carbon dioxide and lactic acid, giving rise to the unique attributes of this fermented product.
Middle East and North Africa: Kishk
The microorganisms responsible for the fermentation of kishk, a traditional Middle Eastern fermented grain product, include Lactobacillus plantarum, Lactobacillus casei, and Lactobacillus brevis, as well as Bacillus subtilis and yeasts.
Asia: Traditional Pickles and Fermented Foods
Lactobacillus brevis KB290 is a plant-derived lactic acid bacterium isolated from "Suguki," a traditional pickle produced in Kyoto, Japan. In Asia, the most common microorganisms found in fermented food are Lactiplantibacillus plantarum, Levilactobacillus brevis, Pediococcus cerevisiae, Acetobacter, and Enterobacter, especially in Korea, China, and Nepal, where these microorganisms are found in fermented vegetables.
Africa: Traditional Fermented Beverages
Lactobacillus brevis was reported among the predominant species during fermentation of Dégué — fermented millet beverages popularly consumed in parts of African countries, namely Burkina Faso, Ivory Coast, Senegal, Mali, Guinea, and Benin Republic.
India: Pozha and South Indian Fermented Foods
The strain L. brevis MYSN105 was isolated from the traditional fermented food Pozha. South Indian tribes have an ancient tradition in food technology, with fermented food being very popular across the country and consumed at breakfast, lunch, and dinner.
Dairy Traditions
Lactobacillus brevis may be used as a probiotic culture and as an adjunct in some cheese varieties, including Canestrato Pugliese, Cheddar, and Ricotta Forte. The production of various foodstuffs using the lactic acid fermentation process is one of the oldest inventions of humanity.
It is important to emphasize that in all traditional contexts, L. brevis was neither isolated nor intentionally administered as a single-strain agent. Rather, it was consumed as a naturally occurring component of fermented foods. The bacterium was not formally described scientifically until the early 20th century. Ancient cultures such as those of Egypt, Rome, Greece, and Mesopotamia used traditional fermented foods and beverages as medicine to treat diseases. However, no historical record specifically attributes medicinal properties to L. brevis in isolation.
3. Key Constituents and Active Compounds
L. brevis exerts its biological effects through several distinct active components and metabolic products, each with characterized or partially characterized mechanisms of action.
γ-Aminobutyric Acid (GABA)
Lactobacillus brevis is an efficient cell factory for producing bioactive γ-aminobutyric acid (GABA) by its gad operon-encoded glutamic acid decarboxylase (GAD) system. Glutamate is transported into the cytosol via GadC and performs an irreversible decarboxylation reaction catalyzed by GAD to produce GABA, which is then released into the extracellular environment via GadC. Genes encoding the glutamate decarboxylase system, including two gad genes (gadA and gadB) and the glutamate antiporter gene (gadC), have been identified. The gadB gene is located adjacent to gadC, while gadA resides separately on the chromosome. The transcriptional regulator gadR was found upstream of gadC.
Gamma-aminobutyric acid (GABA) is a non-protein amino acid that is widely distributed in nature and its physiological importance goes beyond its role as an inhibitory neurotransmitter of the central nervous system in mammals. GABA improves brain cell metabolism by increasing oxygen delivery and blood flow, and is involved in regulating growth hormone secretion, protein production, and lowering blood pressure. Note that these are known pharmacological properties of GABA generally; the degree to which L. brevis-derived GABA specifically influences human systemic GABA levels following oral ingestion has not been definitively established in large-scale human clinical trials.
GABA production begins in the growth phase of bacteria (log phase) and increases close to the stationary phase due to increased GAD enzyme activity. It is an intracellular enzyme produced in response to acidic conditions. In most lactic acid bacteria, its active form is a dimer, but in L. brevis it is a tetramer.
Arginine Deiminase (ADI)
Lactobacillus brevis CD2 is a functional Lactobacillus strain with peculiar biochemical features essentially related to the activity of arginine deiminase. This enzyme catalyzes arginine and affects the biosynthesis of polyamines (putrescine, spermidine, and spermine). Through the arginine-deiminase activity, L. brevis is able to subtract the substrate (arginine) from nitric oxide synthase, and to inhibit in vitro generation of nitric oxide from rat peritoneal macrophages. In in vitro assays, the anti-inflammatory effects of soluble L. brevis CD2 extracts were heavily dependent on the presence of functional arginine deiminase, an enzyme that can inhibit nitric oxide synthesis.
S-Layer Proteins (Surface-Layer Proteins)
Levilactobacillus brevis is a lactic acid bacterium that produces surface-layer proteins (Slps). Multiple S-layer protein genes have been reported in L. brevis genomes, and their potential involvement in its probiotic and biotechnological features has been documented. Research identified Mincle (Macrophage-inducible C-type lectin) as a receptor for the S-layer of L. brevis, modulating bone marrow-derived cell functions. The S-layer/Mincle interaction led to a balanced cytokine response by triggering the release of both pro- and anti-inflammatory cytokines. Within the context of probiotic function, it is the S-layer that attaches to the cellular wall of the gastrointestinal tract.
In the context of antiviral activity, inhibition of herpes simplex virus type 2 (HSV-2) by L. brevis was found to be due to a heat-resistant non-protein compound of greater than 10 kDa, and removal of the S-layer significantly reduced this inhibitory activity.
Lactic Acid and Short-Chain Organic Acids
Fermentation is the most common metabolic pathway in L. brevis and most other lactic acid bacteria. In this pathway, sugar (hexoses) is converted to lactic acid by the 6-phosphogluconate pathway, also producing CO₂ and ethanol. These metabolic products contribute to the acidification of environments such as the vagina and gut, which can competitively inhibit pathogen growth.
Immunomodulatory Metabolites and GABA-Mediated Immune Effects
Investigation of the immunological effects of L. brevis BGZLS10-17 showed that GABA-containing and GABA-free supernatant of this strain have strong immunoregulatory effects on mesenteric lymph node cells. Furthermore, GABA produced by this strain exhibits additional inhibitory effects on proliferation, IFN-γ and IL-17 production, and the expression of MHCII and CD80 on antigen-presenting cells. Supernatants produced by BGZLS10-17 were shown to induce autophagy in CD4⁺ and CD8⁺ T lymphocytes, NK and NKT cells, as well as antigen-presenting cells. Stimulation of Foxp3⁺, IL-10, and TGF-β expression by BGZLS10-17-produced GABA is completely mediated by the induction of ATG5-dependent autophagy.
4. Scientific Evidence by Area of Use
4.1 Oral and Periodontal Health
This is the most consistently studied area of human clinical evidence for L. brevis, with multiple randomized controlled trials (RCTs) conducted.
Periodontal disease and gingivitis: A double-blind, randomized controlled trial aimed to evaluate the efficacy of Levilactobacillus brevis CD2 (CNCM I-5566) in preserving or improving recognized oral health indicators. Thirty consenting healthy adults were randomized to receive four lozenges per day of L. brevis CD2 probiotic (n = 15) or placebo (n = 15) over four weeks. Clinical parameters including full-mouth bleeding on probing (BoP) and plaque index (PI) scores were recorded. Unstimulated saliva was collected to measure salivation rate, pH, and buffer capacity. Salivary biomarkers analyzed included glucose, D-lactate, and secretory immunoglobulins A (sIgA). Parameters were assessed at baseline, after four weeks, and two weeks post-intervention. The trial found significant improvements in bleeding on probing, plaque index, salivation rate, and saliva buffering capacity after four weeks, and reported lower salivary glucose and D-lactate levels, with no adverse effects reported.
Adjunct to professional mechanical plaque removal in periodontitis: A PRISMA 2020–compliant systematic review of five databases identified randomized controlled trials evaluating L. plantarum and L. brevis as adjuncts to professional mechanical plaque removal (PMPR) in periodontitis. Adjunctive subgingival delivery of a probiotic gel containing these species was associated with significant improvements in probing pocket depth (PPD), clinical attachment level (CAL), and IL-10 compared with PMPR alone. Experimental studies showed that these species may exert antimicrobial, anti-inflammatory, and barrier-protective effects by modulating host immune signaling pathways, including suppression of NF-κB activation, regulation of pro- and anti-inflammatory cytokines, and interference with osteoclastogenic signaling. However, these biological mechanisms provide theoretical plausibility only for the modest clinical improvements observed in early-stage disease.
Oral colonization (pilot RCT): A randomized, double-blinded, placebo-controlled pilot study included 40 volunteers (22 females, 18 males; age range 18–55 years) with healthy gingiva or mild gingivitis, allocated to receiving probiotic chewing gum (n = 20) or placebo (n = 20) twice daily for 6 weeks. At baseline and after 6 weeks, saliva samples were assessed for probiotic colonization by qPCR, and dental plaque, gingival index, and dental probing pocket depth in Community Periodontal Index (CPI) teeth were analyzed. Both L. brevis and L. plantarum were detected in the oral microbiota at baseline. After 6 weeks, volunteers receiving the probiotic showed a significant increase of both L. brevis (p = 0.017) and L. plantarum (p = 0.004) versus placebo, an effect that remained significant after adjusting for gender and gingival index at baseline.
Mechanism underpinning periodontal effects: An anti-inflammatory effect of Lactobacillus brevis CD2 administered to patients with chronic periodontitis was reported and related to the capacity of the probiotic to prevent the production of nitric oxide and, consequently, the release of PGE2 and the activation of MMPs induced by nitric oxide. Additionally, L. brevis CD2-treated animals displayed lower counts of anaerobic bacteria but higher counts of aerobic bacteria compared with placebo-treated animals.
Evidence strength assessment: Evidence for oral health benefits — particularly reductions in bleeding on probing, plaque index, and salivary inflammatory markers — is derived from multiple small-to-medium RCTs and a systematic review. Sample sizes are generally modest (n = 15–40 per group), and studies are often short-term (4–6 weeks). The mechanistic basis (arginine deiminase-mediated NO inhibition, S-layer adhesion) is well-characterized in vitro. Overall, evidence is promising and more robust than in other clinical areas for L. brevis, but larger, longer-duration trials are needed.
4.2 Gastrointestinal Health: Irritable Bowel Syndrome (IBS)
Researchers evaluated the effects of Lactobacillus brevis KB290 on IBS symptoms. A placebo-controlled, double-blind, crossover trial enrolled 35 males and females (aged 6 years and above) who had been diagnosed with IBS according to the Rome III criteria. After a 4-week pre-trial observation period, they were administered test capsules containing KB290 or placebo for 4 weeks (consumption period I), followed by a 4-week washout, then the opposite capsule for a further 4 weeks (consumption period II). Further work examined the effect of combined consumption of L. brevis KB290 and β-carotene on minor diarrhea-predominant IBS-like symptoms in healthy subjects in a randomized, double-blind, placebo-controlled parallel-group trial, based on prior evidence that co-administration attenuated murine colitis.
Evidence strength assessment: Evidence for IBS benefit is preliminary. The core RCT was small (n = 35), used a crossover design, and was conducted in a population aged 6 and above — an unusual range for an IBS study. Larger, confirmatory trials in well-defined adult IBS populations using current diagnostic criteria are lacking. This evidence is best characterized as early-stage and hypothesis-generating.
4.3 Immune Function and Influenza
Researchers investigated the efficacy of dietary consumption of Lactobacillus brevis KB290 against influenza in humans by a preliminary intervention study on elementary schoolchildren, using a commercially available probiotic drink. An open-label, parallel-group trial was conducted in two 8-week periods at a 1-month interval in winter 2013/2014. Group A was provided with a bottle of the test drink containing KB290 (about 6 billion colony-forming units) every school day in the first period and had no treatment in the second period, and vice versa for Group B.
Epidemic influenza was not observed during the first period and only two of 1,783 subjects were diagnosed. In the second period, the incidence of influenza in Groups A (no treatment) and B (provided the test drink) was 23.9% and 15.7%, respectively, and the difference was statistically significant (p < 0.001).
KB290 ingestion has been shown to enhance interferon (IFN)-α production in humans.
Evidence strength assessment: The schoolchildren influenza study, while statistically significant and large in absolute subject numbers, was an open-label pilot study without randomization or blinding — critical methodological weaknesses. It cannot control for confounding variables including differences in exposure, hygiene behaviors, and concurrent interventions between groups and periods. The IFN-α enhancement finding requires replication in blinded, controlled trials. This evidence is preliminary.
4.4 Vaginal Health: Bacterial Vaginosis (BV)
A Phase 2 randomized parallel-group prospective placebo-controlled study conducted at 7 clinical centers enrolled 18- to 45-year-old women with recent symptomatic BV cured with metronidazole. Within 48 hours after completion of metronidazole therapy, eligible women received 1 capsule of the verum — containing 5.4 billion Lactobacillus crispatus LMG S-29995, Lactobacillus brevis, and Lactobacillus acidophilus in proportion of 60%, 20%, and 20%, respectively — or placebo, twice daily for the first 7 days and once daily for the next 8 to 120 days. The primary outcome was percentage of recurrence of BV, defined as 3 of 4 Amsel criteria plus abnormal vaginal discharge/vulvar odor during 4 months of intake.
Evidence strength assessment: The BV study examined L. brevis as one of three strains in a combination product; therefore, it is not possible to attribute efficacy specifically to L. brevis from this trial. Evidence for L. brevis specifically in BV remains limited.
4.5 Antiviral Activity: Genital Herpes (HSV-2)
A randomized, double-blind controlled trial compared the efficacy and safety of multistrain probiotic and acyclovir in women patients with recurrent genital herpes simplex virus type 2 (HSV-2) infections. Eighty-one patients enrolled in the study were treated with multistrain Lactobacillus brevis — one vaginal capsule every 12 hours — or oral acyclovir 400 mg twice daily, for 6 months.
Of 53 patients who completed both treatment courses, no important differences were identified between acyclovir and probiotic for the primary and secondary efficacy endpoints: resolution of episode, lesion healing time, viral shedding, and percentage of pain. The median time to first and second recurrence after treatment were 43 and 121 days in patients receiving acyclovir and 33 and 118 days in patients receiving probiotic.
At a mechanistic level, previous work demonstrated that L. brevis cells and their cell wall components inhibit HSV-2 replication. This inhibition is due to a heat-resistant non-protein compound of greater than 10 kDa, and DNA, RNA, and lipids from bacterial cells were devoid of inhibitory effect. Removal of the S-layer significantly reduced the inhibitory activity.
Evidence strength assessment: The genital herpes RCT had significant limitations: only 53 of 81 enrolled patients completed both treatment courses, reducing statistical power; the study used a multistrain product making strain-specific attribution impossible; and the comparator was acyclovir rather than placebo, making it an equivalence rather than superiority trial. Non-inferiority to acyclovir on some endpoints is intriguing but inconclusive. This evidence is preliminary and cannot support definitive clinical claims.
4.6 Dental Caries Risk Reduction
Lactobacillus brevis CD2 has been previously demonstrated to lead to lower plaque acidogenicity compared to a placebo in high caries-risk children. Its caries-relevant activity is linked to the arginine deiminase feature of the strain, which catalyzes arginine and affects the biosynthesis of polyamines. The optimal dose of probiotic strains for caries prevention is yet to be clarified.
Evidence strength assessment: Evidence is limited to small-scale studies and mechanistic data. No large-scale RCTs specifically targeting caries incidence as a primary endpoint for L. brevis have been published. Evidence is early-stage.
5. Body Systems and Health Areas of Association
- Oral/Dental System: Periodontal disease, gingivitis, dental caries risk, oral microbiome modulation, salivary biochemistry (pH buffering, secretory IgA).
- Gastrointestinal System: IBS symptom management, bowel movement regularity, intestinal microflora composition, intestinal barrier integrity.
- Immune System: Interferon-α induction, NK cell activity, T-cell modulation, cytokine regulation (IL-10, TGF-β, IFN-γ, IL-17), dendritic cell function via the Mincle-Syk-Card9 axis.
- Urogenital System: Vaginal microbiome restoration following bacterial vaginosis, antiviral activity against HSV-2, support of healthy lactobacilli-dominated vaginal flora.
- Neurological/Endocrine (indirect, via GABA production): GABA as a neurotransmitter precursor; potential relevance to stress, sleep, and mood — though systemic effects of orally consumed L. brevis-derived GABA have not been confirmed in robust human clinical trials.
6. Dosage Forms and Doses Reported in Studies
Doses of L. brevis in clinical and preclinical studies vary considerably by strain, formulation, and indication. Only doses explicitly stated in the cited sources are listed below.
- Oral lozenges (L. brevis CD2, oral health): Four lozenges per day of L. brevis CD2 probiotic over four weeks, administered to healthy adults (n = 15) in a placebo-controlled RCT.
- Oral/vaginal capsules (multistrain L. brevis, genital herpes): One vaginal capsule every 12 hours for 6 months, as compared with oral acyclovir 400 mg twice daily for 6 months, in a double-blind RCT enrolling 81 patients.
- Oral capsules (L. brevis KB290, IBS): Each capsule contained 0.34–0.38 g KB290 (standard content 0.36 g); study participants included males and females aged 6 years and above diagnosed with IBS by Rome III criteria, administered for 4-week periods.
- Oral probiotic drink (L. brevis KB290, influenza): Approximately 6 billion colony-forming units (CFU) per serving, provided as a bottle of test drink every school day over 8-week periods in an open-label study of 1,783 elementary schoolchildren.
- Vaginal capsules (multistrain, BV): 5.4 billion total CFU per capsule, with L. brevis representing 20% of the formulation (approximately 1.08 billion CFU), administered as a combination product twice daily for the first 7 days and once daily for 8–120 subsequent days.
- GRAS-notified food use (L. brevis Lbr-6108): A GRAS determination for the use of Levilactobacillus brevis Lbr-6108 in yogurt and other dairy products, soy products, beverages, chewing gum, confectionery, snacks, and other foods, at a level of no more than 5.0 × 10¹⁰ CFU per serving.
- Vaginal capsules (L. brevis CD2 for HSV-2): Vaginal use of up to 2 billion CFUs twice daily for up to 6 months has been reported as a dose employed in study conditions.
Note: The optimal dose of probiotic strains for specific indications such as caries prevention is yet to be clarified. No standardized dosing guidelines from regulatory or pharmacopoeial bodies exist specifically for L. brevis as a supplement.
Common Commercial Forms
Lactobacillus brevis is involved in the production of a wide variety of fermented products worldwide. As a supplement or probiotic product, it appears in the following forms, based on those used in cited research:
- Oral lozenges / slow-release oral dissolving tablets (particularly strain CD2 for oral health applications)
- Oral capsules (strains KB290 and others, for systemic/gastrointestinal use)
- Vaginal capsules (for urogenital applications)
- Probiotic drinks and functional beverages (strain KB290)
- Chewing gum formulations (combination products with L. plantarum)
- As a component of multi-strain probiotic capsule formulations
7. Safety Considerations
Regulatory Status
Due to being a member of the microbiota of various traditionally fermented foods, L. brevis has a Generally Recognized as Safe (GRAS) status. The European Qualified Presumption of Safety (QPS) and the American GRAS concepts establish a generic risk assessment approach for biological agents. Both concepts are related but differences exist: QPS provides an assessment tool for the EFSA based on reasonable evidence, while GRAS lays the responsibility on the food business operator.
Antibiotic Resistance Profile
In a formal QPS evaluation of strain KB290, 11 of 14 antibiotics tested showed MICs within QPS criteria limits. However, the MICs of ciprofloxacin, tetracycline, and vancomycin were two, four, and eight times, respectively, the breakpoint MICs suggested by the European Scientific Committee on Animal Nutrition. Using analysis of gapped-genome sequences, no known transferable determinants for tetracycline or vancomycin resistance were found, and conjugation experiments with enterococci produced no transconjugants, strongly suggesting that the resistance traits were not transferable. This study demonstrated that the antibiotic resistance observed was due not to dedicated mechanisms but to intrinsic resistance, and, according to QPS criteria, these results provide safety assurance for the ongoing use of L. brevis KB290 as a probiotic.
General Safety in Healthy Adults
L. brevis KB290 has been reported to be safe for human consumption, tolerant to gastrointestinal juices, and capable of improving human bowel function. In the 2025 oral health RCT, no adverse effects were reported.
Risks in Immunocompromised Individuals
A few recent cases of bacteremia and/or sepsis associated with lactobacilli have been reported in patients with different underlying diseases such as ulcerative colitis in pediatric or adult patients, suggesting that extensive damage of the colonic mucous membrane increases the risk of bacteremia. Although probiotics are generally considered safe, their safety in immunocompromised patients is uncertain. It should be noted that published bacteremia cases in the literature have predominantly involved other Lactobacillus-related species (e.g., L. rhamnosus); no published cases specifically attributing bacteremia to L. brevis were identified in the sources reviewed here. However, the class-level precaution is relevant.
Biogenic Amine Production: Concern in Some Strains
Lactobacillus brevis can, in some circumstances, cause spoilage of various foods and beverages, and is one of the most undesirable beer-spoilage microorganisms. In food fermentation contexts, certain L. brevis strains have been associated with biogenic amine production (putrescine and other polyamines via arginine deiminase), which is a food safety consideration distinct from supplemental use.
Absence of Clinical Safety Data in Special Populations
No large-scale, long-term safety data specific to L. brevis in pregnant women, neonates, or patients with structural cardiac disease are available in the sources reviewed. General safety issues with probiotic lactobacilli — including antimicrobial resistance and recent risk reports in immunocompromised patients and patients with short gut syndrome or under cardio-surgery — have been reviewed.
Interaction with Antibiotics
Because L. brevis strains display intrinsic resistance to certain antibiotics including vancomycin and fluoroquinolones (as established above for KB290), concurrent antibiotic therapy may differentially affect colonization and viability. In the IBS crossover trial, subjects who had been administered antibiotics during the study period were excluded from analysis. This exclusion criterion reflects the recognized possibility that concurrent antibiotic use may confound or nullify probiotic outcomes.
References