TY - JOUR
T1 - Probiotics in Health Care
T2 - A Critical Appraisal
AU - Quigley, Eamonn M.M.
AU - Shanahan, Fergus
N1 - Publisher Copyright:
Copyright © 2025 by the author(s). This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See credit lines of images or other third-party material in this article for license information.
PY - 2025/1/27
Y1 - 2025/1/27
N2 - Consumption of probiotic products continues to increase, perhaps driven by an interest in gut health. However, the field is filled with controversy, inconsistencies, misuse of terminology, and poor communication. While the probiotic concept is biologically plausible and in some cases mechanistically well established, extrapolation of preclinical results to humans has seldom been proven in well-conducted clinical trials. With noteworthy exceptions, clinical guidance has often been derived not from large, adequately powered clinical trials but rather from comparisons of disparate, small studies with insufficient power to identify the optimal strain. The separation of probiotics from live biotherapeutic products has brought some clarity from a regulatory perspective, but in both cases, consumers should expect scientific rigor and strong supporting evidence for health claims.
AB - Consumption of probiotic products continues to increase, perhaps driven by an interest in gut health. However, the field is filled with controversy, inconsistencies, misuse of terminology, and poor communication. While the probiotic concept is biologically plausible and in some cases mechanistically well established, extrapolation of preclinical results to humans has seldom been proven in well-conducted clinical trials. With noteworthy exceptions, clinical guidance has often been derived not from large, adequately powered clinical trials but rather from comparisons of disparate, small studies with insufficient power to identify the optimal strain. The separation of probiotics from live biotherapeutic products has brought some clarity from a regulatory perspective, but in both cases, consumers should expect scientific rigor and strong supporting evidence for health claims.
KW - antibiotic-associated diarrhea
KW - clinical trials
KW - Clostridioides difficile–associated disease
KW - microbiome
KW - necrotizing enterocolitis
KW - probiotics
KW - Probiotics/therapeutic use
KW - Humans
KW - Gastrointestinal Microbiome/physiology
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U2 - 10.1146/annurev-med-042423-042315
DO - 10.1146/annurev-med-042423-042315
M3 - Review article
C2 - 39527719
AN - SCOPUS:85217084667
SN - 0066-4219
VL - 76
SP - 129
EP - 141
JO - Annual Review of Medicine
JF - Annual Review of Medicine
ER -