Synopsis

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

Enterococcus species, particularly Enterococcus faecium, are sometimes used as probiotic strains in some over-the-counter probiotic formulations. The logic behind their use to support or treat the side effects of antibiotics—most notably antibiotic-associated diarrhea (AAD)—is based on their presumed ability to help restore or maintain balance in the gut microbiota that is often disrupted by antibiotic therapy. Several clinical studies and meta-analyses have explored the efficacy of probiotics (including those containing Enterococcus strains) for preventing AAD, with mixed results. While there is robust evidence for some probiotic species (such as Lactobacillus and Saccharomyces boulardii), the evidence specifically for Enterococcus is less consistent and generally weaker.

A few small studies, mostly in Europe and Asia, have suggested that formulations containing Enterococcus faecium (for example, the SF68 strain) may have some benefit in reducing the incidence of AAD and restoring gut flora, but these studies are limited by small sample sizes and methodological concerns. Major clinical guidelines (such as those from the Infectious Diseases Society of America) do not specifically recommend Enterococcus-based probiotics for this indication, and safety concerns remain due to the potential for transferring antibiotic resistance genes. Overall, the scientific evidence for the use of Enterococcus in managing antibiotic side effects is limited and not as strong as for other probiotics, resulting in a modest evidence rating.

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