REVIEW ARTICLE - THE USE OF BIOTHERAPEUTIC AGENTS IN THE PREVENTION AND TREATMENT OF GASTROINTESTINAL-DISEASE

There is presently a lack of well conducted clinical trials demonstrat ing any significant benefits of probiotics in humans. With the excepti on of diarrhoea due to rotavirus infection in children there is little evidence from randomized, double-blind, placebo-controlled studies th at bacterial probiotics have a significant beneficial action in preven ting diarrhoea of any cause, The yeast Saccharomyces boulardii has bee n shown to be of benefit in the prevention of antibiotic-associated di arrhoea but not in preventing infection with Clostridium difficile. S. boulardii may also be of benefit in preventing relapse of C. difficil e infection, Because of the simplicity of in vitro systems and some an imal models, beneficial characteristics of probiotics such as the abil ity of bacteria to bind to epithelial surfaces are not always transfer able to humans, Thus any postulated benefit from consumption of probio tic bacteria should only be accepted as fact after testing in clinical studies, This review outlines our present knowledge of the mode of ac tion of probiotics and presents the data from clinical trials on their use.