Survey and Systematic Literature Review of Probiotics Stocked in Academic Medical Centers within the United States

• Published in: Hospital pharmacy (Philadelphia) 2013-11, Vol.48 (10), p.834-847
• Main Authors: Abe, Andrew M., Gregory, Philip J., Hein, Darren J., Cochrane, Zara Risoldi, Wilson, Amy F.
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 0018-5787; 1945-1253
• DOI: 10.1310/hpj4810-834

Background Probiotics have a wide variation in their effectiveness in preventing or treating conditions due to the varying beneficial effects of specific probiotic strains. In other words, there is no “generic equivalency” between different probiotic species. However, it is has been noted that many practitioners consider probiotics in generic terms and may not realize the impact of these differences between probiotics. Objective The aims of this study were to identify probiotics used in US academic medical centers and to determine whether those probiotics were supported by a reliable evidence base. Methods A phone survey of 126 inpatient pharmacies in US academic medical centers was conducted to determine which probiotics were stocked. A systematic search was conducted to identify relevant studies that were then critically evaluated to determine whether the identified probiotics are supported by a reliable evidence base. Results There was a 90.5% (114/126) response rate of academic medical centers that were contacted through the phone survey. Ten probiotic products were identified through the phone survey. The probiotic most often stocked in academic medical centers was Culturelle (27.2%) followed by Lactinex (25.4%). The systematic search identified evidence that evaluated Culturelle, Florastor, Lactinex, and VSL #3. Of those 4 probiotics, none were supported by a strong evidence base. However, the results suggested that both Culturelle and Florastor appear to be supported by more evidence compared to other probiotics. Conclusion A majority of academic medical centers did not stock a probiotic that was supported by a reliable evidence base.