Synopsis

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

Saccharomyces boulardii is a probiotic yeast with substantial scientific evidence supporting its use to prevent and treat antibiotic-associated side effects, particularly antibiotic-associated diarrhea (AAD) and Clostridioides difficile infection (CDI). Clinical trials and meta-analyses have demonstrated that S. boulardii supplementation during and after antibiotic therapy can reduce the incidence and severity of diarrhea. The proposed mechanisms include restoration of gut microbiota balance disrupted by antibiotics, inhibition of pathogenic bacteria, enhancement of intestinal barrier function, and modulation of the immune response.

Notably, a meta-analysis published in the "American Journal of Gastroenterology" (2012) reviewed 21 randomized controlled trials and found that S. boulardii significantly reduced the risk of AAD in both children and adults. Similarly, other systematic reviews have shown efficacy in reducing recurrence rates of C. difficile-associated diarrhea. S. boulardii appears to be well-tolerated in immunocompetent individuals, with adverse effects being rare.

While the strength of evidence is high, it is important to note that S. boulardii should be used with caution in immunocompromised or critically ill patients due to rare reports of fungemia. Overall, its use to counteract antibiotic side effects is supported by robust clinical data and is reflected in some clinical practice guidelines.

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