Clinical efficacy of drugs based on probiotic strains of Saccharomyces boulardii

Intestinal microflora in terms of the integral body of knowledge about its importance for the human body is now considered as an additional “virtual” organ, producing many biologically active compounds that affect the various properties and functions of the macroorganism: fermentation of non-digestible food polysaccharides, maintenance of the optimal values of the intra-lumen pH and “intestinal barrier”, the activity of the immune system, vitamin status, energy homeostasis, angiogenesis. Saccharomyces boulardii is not a representative of the natural microflora of the human intestine, but, used as a probiotic, interacts with it, restoring the balance of short-chain fatty acids, reducing the levels of bacterial toxins, acting as a surrogate normal microflora until it is restored and replaced by natural representatives. S. boulardii has immunostimulating and anti-inflammatory activity. The results of clinical studies have demonstrated the effectiveness of S. boulardii in correcting pathological conditions associated with Helicobacter pylori, Clostridium difficile, Candida albicans, Salmonella typhimurum, Yersinia enterocolitium, protozoa Entamoeba and in treating irritable bowel syndrome and antibiotic-associated diarrhea. The efficacy of a drug containing S. boulardii has been demonstrated in the article by clinical studies and a clinical example. This drug has proven to be a highly effective and safe probiotic agent for the prevention and treatment of a number of diseases of the gastrointestinal tract with physiologically optimized pharmacodynamic effect that simulates the protective properties of normal human intestinal microflora. When using a drug containing S. boulardii, both adults and children do not have serious side effects, which increases the possibility of its safe use in clinical practice.

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126. McFarland L.V., Surawicz C.M., Greenberg R.N., Elmer G.W., Moyer K.A., Melcher S.A. et al. Prevention of beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol. 1995;90(3):439-448. Available at: https://www.ncbi.nlm.nih.gov/pub-med/7872284.

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130. Duman D.G., Bor S., Ozutemiz O., Sahin T., Oguz D., I§tan F. et al. Efficacy and safety of Saccharomyces boulardii in prevention of antibiotic-associated diarrhoea due to Helicobacterpylori eradication. Eur J Gastroenterol Hepatol. 2005;17(12):1357-1361. doi: 10.1097/00042737-200512000-00015.

131. Duman D.G., Bor S., Ozutemiz O., Sahin T., Oguz D., i§tan F. et al. Efficacy and safety of Saccharomyces boulardii in prevention of antibiotic-associated diarrhoea due to Helicobacterpylori eradication. EurJ Gastroenterol Hepatol. 2005;17(12):1357-1361. doi: 10.1097/00042737-200512000-00015.

132. Cremonini F., Di Caro S., Covino M., Armuzzi A., Gabrielli M., Santarelli L. et al. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol. 2002;97(11):2744-2749. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12425542.

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134. Cindoruk M., Erkan G., Karakan T., Dursun A., Unal S. Efficacy and safety of Saccharomyces boulardii in the 14-day triple anti-Helicobacter pylori therapy: a prospective randomized placebo-controlled doubleblind study. Helicobacter. 2007;12(4):309-316. doi: 10.1111/j.1523-5378.2007.00516.x.

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136. Kotowska M., Albrech P., Szajewska H. Saccharomyces boulardii in the prevention of antibioticassociated diarrhoea in children: a randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther. 2005;21(5):583-590. doi: 10.1111/j.1365-2036.2005.02356.x.

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138. Szajewska H., Mrukowicz J. Metaanalysis: non-pathogenic yeast Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2005;22(5):365-372. doi: 10.1111/j.1365-2036.2005.02624.x.

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140. Luzina E.V. Diarrehea associated with antibiotics. Sibirskiy meditsinskiy zhurnal (Irkutsk) = Siberian Medical Journal (Irkutsk). 2009;(2):122-124. (In Russ.) Available at: https://cyberleninka.ru/article/n/antibiotikoassot-siirovannaya-diareya.

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142. Begaydarova R.Kh., Starikov Yu.G., Alshynbekova G.K., Dyusembaeva A.E., Devdariani Kh.G. The role of enterol (saccharomyces boulardii) in the prevention and treatment of antibiotic-associated diarrhoea in children. Mezhdunarodnyy zhurnal prikladnykh i fundamental’nykh issledovaniy = International Journal of Applied and Fundamental Research. 2017;(11-1):40-44. (In Russ.) Available at: https://applied-research.ru/ru/article/view?id=11927.

143. Billoo A.G., Memon M.A., Khaskheli S.A., Murtaza G., iqbal K., Saeed S.M. et al. Role of a probiotic (Saccharomyces boulardii) in management and prevention of diarrhoea. World J Gastroenterol. 2006;12(28):4557-4560. doi: 10.3748/wjg.v12.i28.4557.

144. Micklefield G. Saccharomyces boulardii in the treatment and prevention of antibiotic-associated diarrhea. MMW Fortschr. Med. 2014;156(1):8-22. (In German) Available at: https://www.ncbi.nlm.nih.gov/pubmed/24930328.

145. Kurugol Z., Koturoglu G. Effects of Saccharomyces boulardii in children with acute diarrhoea. Acta Paediatr. 2005;94(1):44-47. doi: 10.1111/j.1651-2227.2005.tb01786.x.

146. Shan L.S., Hou P, Wang Z.-J., Liu F.-R., Chen N., Csu L-H. Prevention and treatment of diarrhoea with Saccharomyces boulardii in children with acute lower respiratory tract infections. Benef. Microbes. 2013;4(4):329-334. doi: 10.3920/BM2013.0008.

147. Villarruel G., Rubio D.M., Lopez F., Cintioni J., Gurevech R., Romero G., Vandenplas Y Saccharomyces boulardii in acute childhood diarrhoea: a randomized, placebo-controlled study. Acta Paediatr. 2007;96(4):538-541. doi: 10.1111/j.1651-2227.2007.00191.x.

148. Szajewska H., Skorka A., Dylag M. Meta-analysis: Saccharomyces boulardii for treating acute diarrhoea in children. Aliment Pharmacol Ther. 2007;25(3):257-264. doi: 10.1111/j.1365-2036.2006.03202.x.

149. Szajewska H., Skorka A. Saccharomyces boulardii for treating acute gastroenteritis in children: updated meta-analysis of randomized controlled trials. Aliment Pharmacol Ther. 2009;30(9):960-961. doi: 10.1111/j.1365-2036.2009.04113.x.

150. Leont'eva N.i., Shcherbakov i.T., Gracheva N.M., Khrennikov B.N., Solov'eva A.i. Efficiency of probiotic drug “Enterol” effect on processes of reparation of different parts of gastrointestinal mucosa. Ehksperimental’naya i kliniches-kaya gastroehnterologiya = Experimental anf Clinical Gastroenterology Journal. 2015;(5). (in Russ.) Available at: https://cyberleninka.ru/article/n/effek-tivnost-vliyaniya-probioticheskogo-preparata-enterol-na-protsessy-repar-atsii-raznyh-otdelov-slizistoy-obolochkizheludochno.

151. Guarino A., Albano F., Ashkenazi S., Gendrel D., Hoekstra J.H., Shamir R. et al. European Society for Paediatric Gastroenterology, Hepatology, and Nutrition/European Society for Paediatric infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe. J Pediatr Gastroenterol Nutr. 2008;46:S81-S122. doi: 10.1097/MPG.0b013e31816f7b16.

152. McFarland L.V., Surawicz C.M., Greenberg R.N., Fekety R., Elmer G.W., Moyer K.A. et al. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA. 1994;271(24):1913-1918. Available at: https://www.ncbi.nlm.nih.gov/pubmed/8201735.

153. Surawicz C.M., McFarland L.V., Greenberg R.N., Rubin M., Fekety R., Mulligan M.E. et al. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clin Infect Dis. 2000;31(4):1012-1017. doi: 10.1086/318130.

154. McFarland L.V., Elmer G.W., Surawicz C.M. Breaking the cycle: treatment strategies for 163 cases of recurrent Clostridium difficile disease. Am J Gastroenterol. 2002;97(7):1769-1775. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12135033.

155. McFarland L.V. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol. 2006;101(4):812-822. Available at: https://www.ncbi. nlm.nih.gov/pubmed/16635227.

156. Parkes G.C., Brostoff J., Whelan K., Sanderson J.D. Gastrointestinal microbiota in irritable bowel syndrome: their role in its pathogenesis and treatment. Am J Gastroenterol. 2008;103(6):1557-1567. Available at: https://www.ncbi.nlm.nih.gov/pubmed/18513268.

157. McFarland L.V., Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol. 2008;14(17):2650-2661. doi: 10.3748%2Fwjg.14.2650.

158. Choi C.H., Jo S.Y., Park HJ., Chang S.K., Byeon J.S., Myung SJ. A randomized, double-blind, placebo-controlled multicenter trial of Saccharomyces boulardii in irritable bowel syndrome: effect on quality of life. J Clin Gastroenterol. 2011;45(8):679-683. doi: 10.1097/MCG.0b013e318204593e.

159. Bennani A. Randomized trial of Saccharomyces boulardii in the treatment of functional colon disorders. LObjectif Medical. 1990;73:56-61.

160. Maupas J.L., Champemont P., Delforge M. Treatment of irritable bowel syndrome with Saccharomyces boulardii: a double-blind, placebocon-trolled study. Med Chir Dig. 1983;12:77-79.

161. Guslandi M. Treatment of irritable bowel syndrome with Saccharomyces boulardii. J Clin Gastroenterol. 2011;45(8):740-741. doi: 10.1097/MCG.0b013e3182166c76.

162. Monteiro E., Fernandes J.P., Vieira M.R., Correia J.P, Caetano J.M., Ribeiro T. et al. Double blind clinical trial on the use of ultra-levure in the prophylaxis of antibiotic induced gastro-intestinal and mucocutaneous disorders. Acta Med Port. 1981;3(2):143-145. (In Portuguese) Available at: https://www.ncbi.nlm.nih.gov/pubmed/7032230.

163. McFarland L.V., Surawicz C.M., Greenberg R.N., Elmer G.W., Moyer K.A., Melcher S.A. et al. Prevention of beta-lactam-associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol. 1995;90(3):439-448. Available at: https://www.ncbi.nlm.nih.gov/pub-med/7872284.

164. Can M., Beirbellioglu B.A., Avci I.Y., Beker C.M., Pahsa A. Prophylactic Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea: a prospective study. Med Sci Monit. 2006;12(4):PI19-PI22. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16572062.

165. Duman D.G., Bor S., Ozutemiz O., Sahin T., Oguz D., I§tan F. et al. Efficacy and safety of Saccharomyces boulardii in prevention of antibiotic-associated diarrhoea due to Helicobacterpylori eradication. Eur J Gastroenterol Hepatol. 2005;17(12):1357-1361. doi: 10.1097/00042737-200512000-00015.

166. Cremonini F., Di Caro S., Covino M., Armuzzi A., Gabrielli M., Santarelli L. et al. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol. 2002;97(11):2744-2749. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12425542.

167. Cindoruk M., Erkan G., Karakan T., Dursun A., Unal S. Efficacy and safety of Saccharomyces boulardii in the 14-day triple anti-Helicobacter pylori therapy: a prospective randomized placebo-controlled doubleblind study. Helicobacter. 2007;12(4):309-316. doi: 10.1111/j.1523-5378.2007.00516.x.

168. Kotowska M., Albrech P., Szajewska H. Saccharomyces boulardii in the prevention of antibioticassociated diarrhoea in children: a randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther. 2005;21(5):583-590. doi: 10.1111/j.1365-2036.2005.02356.x.

169. Szajewska H., Mrukowicz J. Metaanalysis: non-pathogenic yeast Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2005;22(5):365-372. doi: 10.1111/j.1365-2036.2005.02624.x.

170. Luzina E.V. Diarrehea associated with antibiotics. Sibirskiy meditsinskiy zhurnal (Irkutsk) = Siberian Medical Journal (Irkutsk). 2009;(2):122-124. (In Russ.) Available at: https://cyberleninka.ru/article/n/antibiotikoassot-siirovannaya-diareya.

171. Begaydarova R.Kh., Starikov Yu.G., Alshynbekova G.K., Dyusembaeva A.E., Devdariani Kh.G. The role of enterol (saccharomyces boulardii) in the prevention and treatment of antibiotic-associated diarrhoea in children. Mezhdunarodnyy zhurnal prikladnykh i fundamental’nykh issledovaniy = International Journal of Applied and Fundamental Research. 2017;(11-1):40-44. (In Russ.) Available at: https://applied-research.ru/ru/article/view?id=11927.

172. Micklefield G. Saccharomyces boulardii in the treatment and prevention of antibiotic-associated diarrhea. MMW Fortschr. Med. 2014;156(1):8-22. (In German) Available at: https://www.ncbi.nlm.nih.gov/pubmed/24930328.

173. Shan L.S., Hou P, Wang Z.-J., Liu F.-R., Chen N., Csu L-H. Prevention and treatment of diarrhoea with Saccharomyces boulardii in children with acute lower respiratory tract infections. Benef. Microbes. 2013;4(4):329-334. doi: 10.3920/BM2013.0008.