PHARMACEUTICAL PROBIOTICS FOR THE TREATMENT OF ANAEROBIC AND OTHER INFECTIONS

Pharmaceutical probiotics have been used as alternative treatments or preventative therapies for a variety of clinical diseases. The overuse of antibiotics and emergence of multiple-antibiotic resistant pathoge ns has refocused clinical attention on the field of probiotics. Anaero bic infections which seem to respond well to probiotics are infections which involve the disruption of normal microbial flora. Gastrointesti nal infections (travelers' diarrhea, antibiotic-associated diarrhea, C lostridium difficile disease, rota-virus diarrhea) have been studied u sing the following pharmaceutical probiotics: Saccharomyces boulardii, Lactobacillus casei GG, Lactobacillus acidophilus, Lactobacillus bulg aricus, Bifidobacterium bifidum, Streptococcus thermophilus and Entero coccus faecium. Vaginitis has been experimentally studied using L. aci dophilus and L. casei GG. The efficacy, safety and mechanisms of actio n of these various probiotics are reviewed. Requirements for drug appr oval are similar for biologic probiotics and new drug entities and the se requirements involve preclinical tolerability studies, pharmacokine tic studies and large, well-controlled blinded clinical trials. (C) 19 97 Academic Press.