Extensive clinical evidence has demonstrated the benefits of Saccharomyces boulardii CNCM I-745 to treat, prevent and recover from diarrhea
Saccharomyces boulardii CNCM I-745 is the first yeast probiotic identified1, and has been used as a probiotic in medicine for more than 56 years.
Because of its long history, the clinical evidence of the efficacy of S. boulardii CNCM I-745 has been demonstrated for a number of diarrheal syndromes associated with an imbalance of gut microbiota1, and is prescribed for the prevention and treatment of diarrhea in adults and children for :
- Acute infectious diarrhea – viral or bacterial2 ;
- Antibiotic-associated diarrhea2 ;
- Gastrointestinal side effects associated with Helicobacter pylori eradication therapy2 ;
- Recurrent Clostridium difficle disease following antibiotic treatment.2
Evidence of Saccharomyces boulardii CNCM I-745 for the treatment of acute diarrhea
In children, clinical studies have demonstrated that the administration of S. boulardii CNCM I-745 with standard therapy for acute diarrhea (oral rehydration solution and zinc) significantly reduces the duration of acute diarrhea by 2.1 days.3 In hospitalized and outpatients children, the duration of diarrhea was reduced within 48 hours of receiving S. boulardii CNCM I-745.4
An analysis of 22 clinical trials demonstrated that the duration of acute diarrhea in children was reduced by 19.7 hours compared to control patients who did not receive S. boulardii CNCM I-745.5
In adults (>18 years) with acute diarrhea, S. boulardii CNCM I-745 has been shown to significantly reduce the frequency of acute diarrhea after 48 hours of treatment.6
Evidence of Saccharomyces boulardii CNCM I-745 for the prevention of antibiotic-associated diarrhea
The first randomized-controlled trial to investigate the administration of S. boulardii CNCM I-745 to prevent the development of antibiotic-associated diarrhea (ADD) in children demonstrated that the risk was reduced by 80%.7
Analysis of 21 studies investigating S. boulardii CNCM I-745 treatment to prevent AAD in adults and children demonstrated that there was a 53% reduction in the risk of developing AAD.8
Evidence of Saccharomyces boulardii CNCM I-745 for the prevention of H. pylori eradication therapy-associated gastrointestinal side effects
Antibiotic treatment, which is part of Helicobacter pylori eradication therapy, is associated with multiple side effects including diarrhea. In adults receiving eradication therapy, no patient administered S. boulardii CNCM I-745 experienced diarrhea compared with 9,3% (p = 0.028) of control patients.9 An analysis of 25 clinical studies assessing the incidence of eradication therapy-associated side effects in adults receiving S. boulardii CNCM I-745 reported a 53% reduction in side effects, including 71% of diarrhea.10 A second study that analysed 18 clinical studies in both adults and children demonstrated that the incidence of side effects in patients receiving S. boulardii CNCM I-745 was 18.1% compared to 35.2% for patients only receiving eradication therapy (p <0.00001).11 In particular, S. boulardii significantly reduced the incidence of diarrhea by 67% (p <0.00001).11
Evidence of Saccharomyces boulardii CNCM I-745 for the prevention of recurrent Clostridium difficile infection
Recurrent C. difficile infection is a common consequence of antibiotic therapy. In a study of adult patients, S. boulardii CNCM I-745 significantly reduced the risk of recurrent C. difficile disease (CDD) by 57% compared to control patients.12 This was later confirmed in another study that demonstrated the risk of CDD recurrence was reduced by 66.6% compared to control patients.13
An analysis of clinical studies conducted over 28 years demonstrated a significant reduction in the risk of recurrent CDD associated with AAD by 63% with S. boulardii CNCM I-745 treatment.14
Therefore, there are extensive clinical studies performed that support the indicated use of S. boulardii CNCM I-745 to treat, prevent and recover from diarrhea.
Internal code : 20.10
- 01 . Joly, F et al. 2017. Saccharomyces boulardii CNCM I-745. Marteau, P and Dore J (Ed.), Gut Microbiota: A full-fledged organ. 2017: 305-326. Paris: John Libbey Eurotext. Gut Microbiota Book.
- 02 . S. boulardii CNCM I-745 Summary of Product Characteristics.
- 03 . Burande, MA and Burande, AR. Efficacy of Saccharomyces boulardii strain in acute diarrhoea in children: an Indian perspective. Int J Recent Trends Sci Technol. 2012; 4: 41-44.
- 04 . Dinleyici EC, et al. Saccharomyces boulardii CNCM I-745 reduces the duration of diarrhoea, length of emergency care and hospital stay in children with acute diarrhoea. Beneficial microbes. 2015; 6(4): 415-421
- 05 . Feizizadeh S, Salehi-Abargouei A, and Akbari V. Efficacy and safety of Saccharomyces boulardii for acute diarrhea. Pediatrics. 2014. 134(1): e176-e191.
- 06 . Höchter, W, Chase D and Hagenhoff G. Saccharomyces boulardii in acute adult diarrhoea. Efficacy and tolerance of treatment. Münch Med Wochenschr. 1990; 132: 188-92.
- 07 . Kotowska M, et al. Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea in children: a randomized, double-blind placebo-controlled trial. Alimentary pharmacology & therapeutics. 2005; 21(5): 583-590.
- 08 . Szajewska H, and Kolodziej, M. Systemic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea. Alimentary pharmacology & therapeutics. 2015; 42(7): 793-801.
- 09 . Chotivitayatarakorn P, Mahachai V, and Vilaichone RK. Effectiveness of 7-day and 14-day moxifloxacin-dexlansoprazole based triple therapy and probiotic supplement for Helicobacter pylori eradication in Thai patients with non-ulcer dyspepsia: a double-blind randomized placebo-controlled study. Asian Pacific journal of cancer prevention: APJCP. 2017; 18(10): 2839.
- 10 . McFarland LV, et al. Meta-analysis of single strain probiotics for the eradication of Helicobacter pylori and prevention of adverse events. World Journal of Meta-analysis. 2015; 3(2): 97-117
- 11 . Zhou BG, et al. Saccharomyces boulardii as an adjuvant therapy for Helicobacter pylori eradication: A systematic review and meta‐analysis with trial sequential analysis. Helicobacter. 2019; 24(5): e12651.
- 12 . McFarland LV, 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.
- 13 . Surawicz, CM, et al. The search for a better treatment for recurrent Clostridium difficile disease: use of high-dose vancomycin combined with Saccharomyces boulardii. Clinical infectious diseases. 2000; 31(4): 1012-1017.
- 14 . McFarland, LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. The American journal of gastroenterology. 2006; 101(4): 812.