Clinical Guide to Probiotic Products Available in Canada and in US: 2020 Edition

Objective: This guide is designed to translate scientific evidence available for probiotic products into practical, clinically relevant information, enabling clinicians to easily select the appropriate product, dose, and format for a specific indication. There is evidence to support the use of probiotic products for a variety of indications beyond gut health, however, applications and results are strain-specific. Due to frequent changes in commercial availability of probiotic strains, new published evidence, and growing research, an annual review and updates of this Clinical Guide have been conducted since 2008.

Methods: A systematic literature review using pre-defined inclusion criteria was undertaken to identify studies of defined clinical outcomes for specific probiotic strain(s). Commercially available products containing said strain(s) were identified, and the levels of evidence were used to rate the strength of the expected benefit. This information was compiled into a chart format. Data was assessed by a group of independent expert reviewers. In the case of probiotics, the clinical evidence must be linked to specific formulations as defined by genus, species, alphanumeric designation or strain, number of live bacteria present, and the blend of probiotic strains present. Every attempt was made by the author and reviewers to include the published clinical data for the available probiotic formulations. To avoid selection bias toward any specific formulation, we have conducted a literature search of two databases (PubMed, EMBASE) and contacted our independent experts to identify any published or unpublished studies.

Results: In the clinical guide, the available strains were organized based on probiotic strain(s), doses, and evaluated levels of evidence based on our pre-defined criteria. Conclusion: There is evidence to support the use of probiotic products for various aspects of human health, however applications and results are strain-specific. Lack of adverse effects supports the wide use of these products, and further investigation is recommended.

Author(s): Dragana Skokovic-Sunjic

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