Nancy Toedter Williams


Am J Health Syst Pharm. 2010;67(6):449-458. 

In This Article

Precautions and Contraindications

Since probiotics contain live microorganisms, there is a slight chance that these preparations might cause pathological infection, particularly in critically ill or severely immunocompromised patients. Probiotic strains of Lactobacillus have also been reported to cause bacteremia in patients with short-bowel syndrome, possibly due to altered gut integrity.[57,58,72,73] Caution is also warranted in patients with central venous catheters, since contamination leading to fungemia has been reported when Saccharomyces capsules were opened and administered at the bedside.[68,73]

Lactobacillus preparations are contraindicated in persons with a hypersensitivity to lactose or milk.[75]S. boulardii is contraindicated in patients with a yeast allergy.[73,76] No contraindications are listed for bifidobacteria, since most species are considered nonpathogenic and nontoxigenic.[57,72]


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