Probiotics in clinical practice: a critical review of the evidence

The interaction of the gastrointestinal microflora with the human host has been the subject of considerable debate in the last decade. Manipulation of the enteric microflora with probiotic organisms has been attempted in a wide range of clinical settings, in the hope of achieving health benefits in the host. This review presents the evidence from human clinical trials of probiotics in the areas of diarrhoeal illness, inflammatory bowel disease, surgical prophylaxis, critical care and serum lipid modulation. With the exception of childhood viral diarrhoea, there is little evidence to support the use of probiotics in clinical practice at present. There are, however, sound theoretical reasons to support the role of probiotics in many other disease states. (C) 2001 Elsevier Science Inc. All rights reserved.