Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Saccharomyces boulardii is a probiotic yeast with substantial scientific evidence supporting its use in preventing and treating antibiotic-associated side effects, particularly antibiotic-associated diarrhea (AAD) and Clostridioides difficile infections. Antibiotics, while targeting pathogenic bacteria, also disrupt the normal gut microbiota, increasing the risk of diarrhea and opportunistic infections. Multiple randomized controlled trials and meta-analyses have demonstrated that S. boulardii supplementation can significantly reduce the incidence and severity of AAD. The proposed mechanisms include competitive exclusion of pathogenic organisms, enhancement of gut barrier function, stimulation of immune responses, and production of enzymes that neutralize bacterial toxins.

Notably, a 2015 Cochrane review analyzed data from 31 trials and concluded that probiotics, including S. boulardii, reduced the risk of AAD by approximately 51% in children and adults. Specific studies have shown that S. boulardii is effective in preventing recurrence of C. difficile-associated diarrhea, a serious complication of antibiotic therapy. The World Gastroenterology Organisation and several clinical guidelines recognize S. boulardii as a supportive adjunct to antibiotics for these conditions.

Overall, the use of S. boulardii to mitigate antibiotic side effects is well-supported by clinical research, making it one of the most evidence-based probiotic interventions for this purpose. However, while generally safe, its use is not recommended in severely immunocompromised patients due to rare cases of fungemia.

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