Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Bacillus species, especially Bacillus clausii and Bacillus coagulans, are used as probiotics to support antibiotic therapy and to serve as alternatives or adjuncts. The main rationale is their ability to survive gastric acidity, colonize the gut, and help restore the intestinal microbiota disrupted by antibiotics. Several randomized controlled trials and meta-analyses (notably with Bacillus clausii) have shown that supplementation with Bacillus can reduce the incidence and severity of antibiotic-associated diarrhea (AAD), including in pediatric populations. The mechanism is thought to involve competitive exclusion of pathogens, modulation of immune responses, and secretion of antimicrobial substances.

However, while there is moderate evidence for Bacillus in reducing AAD, the evidence for Bacillus as a direct alternative to antibiotics in treating infections is limited and mostly preclinical. Most studies support its role as an adjunct, not a replacement, for antibiotics. Regulatory agencies in several countries (e.g., Italy, India) acknowledge Bacillus-based probiotics as supportive agents during antibiotic use. Overall, the evidence supports Bacillus as a scientifically validated adjunct to antibiotics for mitigating side effects, rather than as a primary alternative to antibiotics for infection control.

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