Lactic-acid-producing Organisms

Lactic-acid-producing Organisms

Drug Nomenclature

Date of monograph revision: 24-Mar-1998; 01-Sep-1998; 06-Apr-2001; 12-Nov-2001; 17-Jun-2004; 25-Jul-2006

Drug Profile

Lactic-acid-producing organisms were introduced as therapeutic agents with the idea of acidifying the intestinal contents and thus preventing the growth of putrefactive organisms. Live cultures designed to restore or maintain a healthy microbial flora have been referred to as probiotics. Lactobacillus bulgaricus, which occurs in naturally soured milk, was the organism originally used but it can be difficult to obtain growth of this organism in the intestines and L. acidophilus, which is an inhabitant of the human intestine, is preferred by many.

Preparations containing various Lactobacillus spp. and other lactic-acid-producing organisms have been used in the treatment of vaginal and gastrointestinal disorders but evidence to support this use is limited. Other organisms that have been tried include Bifidobacterium bifidum, Enterococcus and Streptococcus spp., and the yeast Saccharomyces boulardii. Natural yogurt is a common source of lactic-acid-producing organisms.

A vaccine produced from strains of lactobacillus found in women with trichomoniasis has been used in the prophylaxis of recurrent trichomoniasis (see Go to Trichomoniasis Vaccines).

Reviews1-5 and studies6-14 concerning the use of lactic-acid-producing organisms including Lactobacillus spp., Bifidobacterium bifidum, and Streptococcus thermophilus have been published. However, some preparations have been found to contain smaller quantities or different species of organisms to those specified on the label.15

Metabolic acidosis has occurred after use of tablets containing Lactobacillus acidophilus.16 Cases of infection associated with the use of lactic-acid-producing organisms seem to be very rare,17 although fungaemia associated with the use of Saccharomyces boulardii18 and sepsis associated with Lactobacillus spp.19 have been reported.

  1. 1. Scott E, Li Wan Po A. Lactobacillus. Pharm J 1990; 245: 698–9.
  2. 2. Fuller R. Probiotics in human medicine. Gut 1991; 32: 439–42. PubMed
  3. 3. Drutz DJ. Lactobacillus prophylaxis for Candida vaginitis. Ann Intern Med 1992; 116: 419–20. PubMed
  4. 4. Roffe C. Biotherapy for antibiotic-associated and other diarrhoeas. J Infect 1996; 32: 1–10. PubMed
  5. 5. Van Niel CW, et al. Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics 2002; 109: 678–84. PubMed
  6. 6. Bausserman M, et al. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. J Pediatr 2005; 147: 197–201. PubMed
  7. 7. O'Mahony L, et al. Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology 2005; 128: 541–51. PubMed
  8. 8. Bin-Nun A, et al. Oral probiotics prevent necrotizing enterocolitis in very low birth weight neonates. J Pediatr 2005; 147: 192–6. PubMed
  9. 9. Lin HC, et al. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics 2005; 115: 1–4. PubMed
  10. 10. Rinne M, et al. Effect of probiotics and breastfeeding on the bifidobacterium and lactobacillus/enterococcus microbiota and humoral immune responses. J Pediatr 2005; 147: 186–91. PubMed
  11. 11. Banaszkiewicz A, Szajewska H. Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constipation in children: a double-blind, placebo-controlled randomized trial. J Pediatr 2005; 146: 364–9. PubMed
  12. 12. Weizman Z, et al. Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 2005; 115: 5–9. PubMed
  13. 13. Rosenfeldt V, et al. Effect of probiotics on gastrointestinal symptoms and small intestinal permeability in children with atopic dermatitis. J Pediatr 2004; 145: 612–6. PubMed
  14. 14. Pirotta M, et al. Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomised controlled trial. BMJ 2004; 329: 548. PubMed
  15. 15. Hamilton-Miller JMT, et al. "Probiotic" remedies are not what they seem. BMJ 1996; 312: 55–6. PubMed
  16. 16. Oh MS, et al. d-Lactic acidosis in a man with short-bowel syndrome. N Engl J Med 1979; 301: 249–52. PubMed
  17. 17. Borriello SP, et al. Safety of probiotics that contain lactobacilli or bifidobacteria. Clin Infect Dis 2003; 36: 775–80. PubMed
  18. 18. Piarroux R, et al. Are live saccharomyces yeasts harmful to patients? Lancet 1999; 353: 1851–2. PubMed
  19. 19. Land MH, et al. Lactobacillus sepsis associated with probiotic therapy. Pediatrics 2005; 115: 178–81. PubMed

Preparations

Single-ingredient Preparations

The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed.

Argentina: Acidofilofago; Flevic; Floratil; Lactinex; Tropivag; Australia: Acidophilus Tablets¤; Bioglan Acidophilus; Bioglan Superdophilus; Candi-Biffidus¤; Ethical Nutrients Inner Health Powder¤; Ethical Nutrients Maxi Bifidus¤; Ethical Nutrients Maxi Dophilus¤; Mega Acidophilus¤; ProTract; Austria: Antibiophilus; Bioflorin; Doederlein; Lactofit¤; Reflor; Symbioflor Enterococcus; Belgium: Bioflorin¤; Lacteol; Perenterol¤; Brazil: Bac Resistente¤; Camboacy¤; Flomicin; Floratil; Florent; Lactipan; Leiba; Canada: Bacid; Chile: Bio-Flora; Biolactus; Gastrofloral; Lacteol Forte; Lactil; Perenteryl; Perocur; Czech Republic: Enterol; Santax S; Solco-Trichovac; Denmark: Paraghurt; Precosa; Finland: Lactophilus; Precosa; France: Bacilor; Bioprotus; Diarlac¤; Gynophilus; Lacteol; Lyo-Bifidus; Proflor¤; Rhino-Lacteol¤; Ultra-Levure; Ultraderme¤; Germany: Acidophilus¤; Diarrhoesan SC¤; Hylak N; Hylak Plus; Infectodiarrstop GG¤; Lacteol; Omniflora Akut; Omnisept¤; Paidoflor; Perenterol; Perocur; Santax S; Symbioflor 1; Vagiflor; Yomogi¤; Greece: Ultra-Levure; Hong Kong: Bioflor; Lacteol; Solco-Trichovac¤; India: Myconip; Sporlac; Italy: Bioflorin; Codex; Dicoflor; Ecoflorina; Fermenturto¤; Hygine In¤; Inulac; Lab/A¤; Lacteol; Lactomicina-R¤; Lactonorm; Ramno Fix; Ramno-Flor; Regolact Plus; Mexico: Floratil; Lacteol Fort; Lactipan; Lactovita; Liolactil; Neoflor; Sinuberase; Norway: Precosa¤; New Zealand: Blis K12 Throat Guard; Portugal: Antibiophilus; Enterol; Lacteol; UL 250¤; Russia: Enterol (Ентерол); Gastropharm (Гастрофарм); IRS 19 (ИРС 19); South Africa: Actiflora¤; Enpac¤; Inteflora; Singapore: Lacteol; Spain: Casenfilus; Electrolactil Sol¤; Lacteol; Lactofilus; Lactoliofil¤; Ultra-Levura; Sweden: Precosa; Trevis¤; Switzerland: Bioflorin; Fiormil¤; Florosan; Lacteol; Lactoferment; Perenterol; SolcoTrichovac Lyophilisat; Ultra-Levure; Ventrux¤; Thailand: Lacbon; Lacteol; United Kingdom: Bio Acidophilus; Biodophilus; Culturelle LCG¤; United States: Acidophilus; Bacid; Intestinex; Kala; Lactinex; Lacto-Key; MoreDophilus; Pro-Bionate; Superdophilus; Venezuela: Florestor; Lacteol; Liolactil; Proflor;

Multi-ingredient Preparations

The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed.

Argentina: Bioflora; Biol Preo; Factor Bioenterico; Faelac¤; Nilflux; Totalflora; Tropivag Plus; Australia: Acidophilus Bifidus¤; Acidophilus Complex¤; Acidophilus Plus; Cyto-Bifidus; Enterocare¤; Lactobac¤; Medifem¤; Natures Own Acidophilus Plus¤; Natures Way Acidophilus Plus¤; Ultra Strength Megadophilus¤; Austria: Gynoflor; Hylak Forte; Hylak; Hylakombun¤; Infloran; Omniflora; Prosymbioflor; Trevis; Belgium: Gynoflor; Brazil: Lactipan¤; Canada: Fermalac Vaginal; Fermalac¤; Sisu-Dophilus Plus¤; Chile: Bion 3; Czech Republic: Fermalac Vaginal; Gynoflor; Hylak Forte; Imudon; IRS 19; Lacidofil; Solco-Urovac; France: Actyfilus; Ampho-Vaccin intestinal¤; Ampho-Vaccin urinaire¤; Biolactyl¤; Biolactyl; Ergyphilus; Florgynal; Imudon¤; IRS 19¤; Maxi-Flore; Ophidus; Triphidus; Trophigil; Ultrabiotique; Germany: Antiprurit¤; Eksalb Simplex¤; Eksalb¤; Ferro-Kombun N¤; Gynoflor; Helobaktil¤; Hylak Forte N¤; Imbak¤; IRS 19; Kolpicortin¤; Omniflora¤; Pro-Symbioflor; Ribolac¤; SolcoUrovac¤; Tricho-Kolpicortin¤; Hong Kong: Gyno-Flor E¤; Infloran; Shin-Biofermin S; Hungary: Gynoflor; India: ABClox; Ampilox-LB; Amplus; Ampoxin-LB; Bicidal Plus; Bifilac; Biomoxil-LB; Campicillin Plus; Cefix LB; Cephadex LB; Clax; Imox-Clo LB; Lactisyn; LMX; Megaclox LB; Novaclox LB; Novamox LB; Nutrolin-B; Symbiotik; Vitazyme; Vizylac; Italy: Al-Flor¤; Alvear Complex¤; Bifilact; Bio Flora; Biolactine; Colifagina; Decon Lavanda; Ecoendocilli Testimonia¤; Ecofermenti; Endolac; Enterolactis; Enteroseven; Ergozim Lactis¤; Fermenturto-Lio; Flar¤; Florbiox; Florelax; Floridral; Gastroenterol; Giflorex; Ginil; Infloran; Kiri; Lactipan; Lactisporin; Lactivis; Lactivis; Lactogermine; Lactolife; Lactovit¤; Liozim; Neo Lactoflorene; Neogyn; Ninfagin; Pentaglucano¤; Probiox¤; Prontomixin¤; Vaxitiol; Yovis; Yovita; Mexico: Neo-Panlacticos Plus; Neo-Panlacticos; Pro-T-Flor; Portugal: Benflorene¤; Coli-Fagina S; Infloran; Russia: Bifiform (Бифиформ); Hylak Forte (Хилак Форте); Imudon (Имудон); Linex (Линекс); SolcoTrichovac (Солкотриховак); South Africa: Culturelle VC; Culturelle; Culturelle; Eksalb¤; Spain: Acidona¤; Antibiofilus¤; Infloran; Lactolaxine¤; Switzerland: Gynoflor; Infloran; Ribolac; SolcoTrichovac; SolcoUrovac¤; Thailand: Infloran; United Kingdom: Acidophilus Plus; Beneflora; Biosym¤; Culture Care; Fibre Dophilus; Natudophilus; United States: Acidophilus with Bifidus; Entrin Acidophilus¤; Entrin Bifidus¤; Floranex; SynBiotics-3;



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