: 

Mucosal Immunology (Fourth Edition), 20 Lactobacilli are small,

slender, nonmotile, gram-positive bacilli in chains. Immature colonies
appear smooth, convex, and translucent. Organisms are
microaerophilic or anaerobic and oxidase and catalase negative; they
hydrolyze esculin and ferment carbohydrates.
The strongest evidence for the clinical effectiveness of probiotics has been in the treatment of
acute diarrhea, most commonly due to rotavirus, and pouchitis. More research is needed to
clarify the role of probiotics for preventing antibiotic-associated diarrhea, Clostridium difficile
infection, travelers’ diarrhea, irritable bowel syndrome, ulcerative colitis, Crohn’s disease, and
vulvovaginal candidiasis. There is no consensus about the minimum number of microorganisms
that must be ingested to obtain a beneficial effect; however, a probiotic should typically contain
several billion microorganisms to increase the chance that adequate gut colonization will occur.
Probiotics are generally considered safe and well tolerated, with bloating and flatulence
occurring most frequently. They should be used cautiously in patients who are critically ill or
severely immunocompromised or those with central venous catheters since systemic infections
may rarely occur. Bacteria-derived probiotics should be separated from antibiotics by at least two
hours.
Kumar, B. V., Vijayendra, S. V. N., & Reddy, O. V. S. (2015). Trends in dairy and non-dairy
probiotic products-a review. Journal of food science and technology, 52(10), 6112-6124.
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Millette, M., Luquet, F. M., Ruiz, M. T., & Lacroix, M. (2008). Characterization of probiotic
properties of Lactobacillus strains. Dairy Science and Technology, 88(6): 695-705.
Marteau, P. R., Vrese, M. D., Cellier, C. J., & Schrezenmeir, J. (2001). Protection from
gastrointestinal diseases with the use of probiotics. The American journal of clinical
nutrition, 73(2):430s-436s.
O’May, G. A., & Macfarlane, G. T. (2005). Health claims associated with probiotics. Probiotic
dairy products, 13(4):138-166
Rastall, R. A., Gibson, G. R., Gill, H. S., Guarner, F., Klaenhammer, T. R., Pot, B., ... & Sanders,
M. E. (2005). Modulation of the microbial ecology of the human colon by probiotics, prebiotics
and synbiotics to enhance human health: an overview of enabling science and potential
applications. FEMS microbiology ecology, 52(2):145-152.