Saccharomyces boulardii

Saccharomyces boulardii

• Saccharomyces boulardii is a yeast species. In the Western world, it was discovered by a French microbiologist in 1920s who noted that certain people drinking a tea made from lychee and mangosteen did not develop cholera.

• He isolated Saccharomyces boulardii from this tea. S. boulardii works as a probiotic; it is thought to transiently colonize the gut microbiota to minimize pathogenic microor-ganisms from growing and produce bioactive metabolites.

Dosage:

• For adults, doses of 250-500 mg (about 5-10 billion colony-forming units) for up to 4 weeks. Some studies have examined up to 1000 mg for potentially up to 4 weeks. In infants, doses of 50-200 mg/kg daily for up to 28 days.

• A variety of formulations are available of S. boulardii but not all have been studied to be found effective. The main uses of S. boulardii include:

• Diarrhea and antibiotic-induced diarrhea: In children, it has been shown to decrease acute diarrheal episodes. In adults, there is conflicting evidence regarding antibiotic-induced diarrhea (AID).

• Some studies, including meta-analyses, have shown that it can prevent or reduce AID if started within 48 h of antibiotics while other studies show no difference between groups taking and not taking S. boulardii.

• Clostridium difficile (C. diff) diarrhea: A 2015 meta-analysis that showed S. boulardii reduced acute diarrheal episodes in adults and children found that it, also, reduced the occurrence of C. diff in children but not adults.

• The Infectious Disease Society does not recommend the use of probiotics, including S. boulardii, for prevention of C. diff infections due to insufficiency evidence.

• Helicobacter pylori: A 2019 systematic review with a meta-analysis showed that S. boulardii can improve eradication rates of H. pylori when used conjointly with triple therapy while also reducing gastrointestinal side effects.

• The dosage studied was 100-1000 mg for 1-4 weeks. Necrotizing enterocolitis: A 2021 systematic review with meta-analysis showed that S. boulardii can prevent necrotizing enterocolitis, reducing feeding intolerance and hospitalization time. However, there was no effect on mortality or progression to sepsis.

Safety:

• This is a relatively safe probiotic. Some studies report rare cases of fungemia in older adults, immunocompromised patients and adults with central venous catheters. People with a yeast allergy may be allergic to this and other probiotics.

Medication Interactions:

• A minor interaction with antifungals.