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S. boulardii CNCM I-745 is a probiotic that offers more than one gastrointestinal benefit

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Saccharomyces boulardii CNCM I-745 is complete solution for addressing the symptoms and causes of diarrhea

The single-strain yeast probiotic Saccharomyces boulardii CNCM I-745 is a probiotic drug with a long history and proven mechanisms of action that addresses the causes and symptoms of diarrhea.1

The yeast was discovered in 19232 in the jungles of South East Asia when a visiting microbiologist saw that people who drank a concoction made from the skins of mangosteens and litchis did not develop diarrhea.2 The microbiologist subsequently isolated the protective element and named it Saccharomyces boulardii CNCM I-745.1

S. boulardii CNCM I-745 is the first yeast identified and used as a probiotic in human medicine1, and has been used as a probiotic to prevent, treat and recover from gastrointestinal disorders associated with a disturbance of the gut ecosystem since 1956. This unique yeast has more than 100 clinical studies demonstrating its efficacy as well as extensive scientific evidence highlighting its multiple mechanisms of action.3


Based on the extensive clinical evidence S. boulardii CNCM I-745 is used in many countries for the prevention and treatment of diarrhea in adults and children for : 1


It has also been demonstrated to rapidly restore the balance of beneficial microbes (microbiota) in the gut following a disturbance such as caused by antibiotic treatment.2


Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii CNCM I-745

While they are a large proposed therapy against infectious diseases, commonly used antibiotics can cause a 25% drop in the beneficial bacteria found in the gut.4 This loss means that there is an imbalance in the composition and diversity of gut microbiota, and can be skewed towards consisting of greater numbers of harmful bacteria that cause diarrhea.5,6 Therefore, it is very important to maintain the intestinal microbiota intact as it acts as a barrier against harmful bacteria and prevents antibiotic-associated diarrhea from occurring7.

Did you know? Up to 35% of adults taking antibiotics will experience diarrhea.8

Studies have demonstrated that administering S. boulardii CNCM I-745 at the same time as antibiotics reduces the incidence of diarrhea in both children and adults.9–11 Furthermore, the yeast induces a rapid recovery of the normal beneficial microbiota following antibiotic treatment.2

In addition, one advantage of taking S. boulardii CNCM I-745 is that unlike bacterial probiotics, it is naturally non-susceptible to antibiotics meaning that it can be taken at the same time as antibiotics.12


Prevention of recurrent Clostridium difficile infection by Saccharomyces boulardii CNCM I-745

During an antibiotic treatment, patients often develop diarrhea and the most frequent harmful bacterium causing it is C. difficile13.

C. difficile can result in very serious complications such as colitis, and even death.13,14

One problem with C. difficile is that once someone has had an infection, the risk of a second (recurrent) infection is increased by 20%.13

Studies have shown that Saccharomyces boulardii CNCM I-745 treatment reduces the risk of recurrent C. difficile infections if administered during or following antibiotic treatment.13,15


Saccharomyces boulardii CNCM I-745 for the prevention of gastrointestinal side-effects associated with Helicobacter pylori eradication therapy

H. pylori is a pathogenic bacterium that colonizes the stomach. It’s really important to consider to untreated H. pylori infections can result in ulcers, dyspepsia and even cancer. Standard therapy for the eradication and treatment of H. pylori infection includes antibiotics.16 However, this treatment strategy is associated with gastrointestinal side effects including nausea, abdominal bloating and, diarrhea.17 Therefore it is important to maintain antibiotic treatment.17

Along with studies demonstrating that it can prevent diarrhea associated with antibiotic treatment, S. boulardii CNCM I-745 has been shown to be able to reduce the incidence of gastro-intestinal side effects associated with H. pylori eradication therapy, in particular diarrhea.17

In fact, the evidence of its efficacy is so compelling that a panel of experts organised to address the management of H. pylori included S. boulardii in its recommendations (and this committee stated that only some probiotics have demonstrated efficacy to address H. pylori eradication therapy-associated side effects!).16


Treatment and prevention of acute diarrhea by Saccharomyces boulardii CNCM I-745

Acute infectious diarrhea is the most common form of childhood diarrhea and can result from bacterial infections, viruses or parasites.18,19

Globally, there are ~1.7 billion cases of childhood diarrhea each year.18
Untreated, acute diarrhea can lead to severe dehydration and malnutrition, which can be lethal in young children and the elderly if not addressed quickly.18

Preventing diarrhea through measures such as clean and safe drinking water, hygienic food preparation and improved sanitation are the first steps to preventing acute diarrhea infections.18 It has also been demonstrated that probiotics can be an additional therapy to reduce symptoms of acute diarrhea.20 Saccharomyces boulardii CNCM I-745 treatment results in restoration of the gut ecosystem during and after diarrhea1, and has demonstrated clinical evidence to prevent new cases of acute diarrhea in children.21

Oral rehydration solution (ORS), zinc and nutrient-rich food are the standart therapy for treating acute diarrhea in children 18,19. In addition, some anti-diarrheals, such as the probiotic Saccharomyces boulardii CNCM I-745 are also recommended as an additional treatment to reduce the duration of diarrhea. It is shown that adding Saccharomyces boulardii to ORS will reduce the duration of diarrhea by approximately one day22 and may prevent new cases21 and protect gut ecosystem2


Saccharomyces boulardii CNCM I-745 creates the right environment for beneficial microbiota

The normal composition and diversity of gut microbiota influence and contribute to healthy gut functioning through mechanisms such as nutrient digestion and fermentation, as well as the production of substances that promote normal gut cell function and growth.2

There are various factors that can have a negative impact on the diversity and composition of microbiota, such as poor diet, illness, age, as well as medications (for example antibiotics).2 However, probiotics such as Saccharomyces boulardii CNCM I-745 exert a positive influence on the microbiota.2

Through its multiple proven mechanisms of action, S. boulardii CNCM I-745 either directly or indirectly creates the right environment for the beneficial microbiota, which encourages a rapid restoration to normal composition and diversity2. S. boulardii CNCM I-745 can prevent the overgrowth of harmful bacteria that could outcompete with the beneficial bacteria, it stimulates the immune system, and reduces inflammation and diarrhea that can lead to a loss of microbiota.2 Furthermore, the yeast passes quickly through the intestinal tract meaning that it does not permanently colonise the gut.2



Internal code : 20.56


  • 01 . Joly F, Nuzzo A, Czeruchka D. Saccharomyces boulardii CNCM I-745. In: Marteau P, Dore J, eds. Gut Microbiota: A Full-Fledged Organ. Paris: John Libbey Eurotext; 2017:305-350.
  • 02 . Moré MI, Swidsinski A. Saccharomyces boulardii CNCM I-745 supports regeneration of the intestinal microbiota after diarrheic dysbiosis – A review. Clinical and Experimental Gastroenterology. 2015;8:237-255. doi:10.2147/CEG.S85574
  • 03 . Based on PubMed search., search term “boulardii.”
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  • 04 . Panda S, El Khader I, Casellas F, et al. Short-term effect of antibiotics on human gut microbiota. PLoS ONE. 2014;9(4). doi:10.1371/journal.pone.0095476
  • 05 . McFarland L V. Epidemiology, Risk Factors and Treatments for Antibiotic-Associated Diarrhea. Digestive Diseases. 1999;16(5):292-307. doi:10.1159/000016879
  • 06 . Francino MP. Antibiotics and the human gut microbiome: Dysbioses and accumulation of resistances. Frontiers in Microbiology. 2016;6(JAN):1-11. doi:10.3389/fmicb.2015.01543
  • 07 . McFarland L V. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. American Journal of Gastroenterology. 2006;101(4):812-822. doi:10.1111/j.1572-0241.2006.00465.x
  • 08 . McFarland L V. Antibiotic-associated diarrhea: Epidemiology, trends and treatment. Future Microbiology. 2008;3(5):563-578. doi:10.2217/17460913.3.5.563
  • 09 . Shan LS, Hou P, Wang ZJ, et al. Prevention and treatment of diarrhoea with Saccharomyces boulardii in children with acute lower respiratory tract infections. Beneficial Microbes. 2013;4(4):329-334. doi:10.3920/BM2013.0008
  • 10 . Kotowska M, Albrecht P, Szajewska H. Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: A randomized double-blind placebo-controlled trial. Alimentary Pharmacology and Therapeutics. 2005;21(5):583-590. doi:10.1111/j.1365-2036.2005.02356.x
  • 11 . Can M, Beşirbellioglu BA, Avci IY, Beker CM, Pahsa A. Prophylactic Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea: A prospective study. Medical Science Monitor. 2006;12(4):2004-2007.
  • 12 . Neut C, Mahieux S, Dubreuil LJ. Antibiotic susceptibility of probiotic strains: Is it reasonable to combine probiotics with antibiotics? Medecine et Maladies Infectieuses. 2017;47(7):477-483. doi:10.1016/j.medmal.2017.07.001
  • 13 . Surawicz CM, McFarland L V., Greenberg RN, 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. doi:10.1086/318130
  • 14 . Marteau P. Infectious diarrhea and antibiotic-associated diarrhea. In: Marteau P, Dore J, eds. Gut Microbiota: A Full-Fledged Organ. Paris: John Libbey Eurotext; 2017:103-112.
  • 15 . McFarland L V, Surawicz CM, Greenberg RN, 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.
  • 16 . Malfertheiner P, Megraud F, O’Morain C, et al. Management of helicobacter pylori infection-the Maastricht V/Florence consensus report. Gut. 2017;66(1):6-30. doi:10.1136/gutjnl-2016-312288
  • 17 . McFarland L V. 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. doi:10.13105/wjma.v3.i2.97
  • 18 . World Health Organisation. WHO Diarrheal Disease Fact Sheet. Published 2017. Accessed February 24, 2020.
  • 19 . World Gastroenterology Organisation. Practice guideline for acute diarrhea in adults and children: A global perspective. World Gastroenterology Organisation Global Guidelines. 2012;(February):3-4.
  • 20 . Guarner F, Sanders M, Eliakim R, et al. Probiotics and prebiotics. World Gastroenterology Organisation Global Guidelines. 2017:1-35.
  • 21 . Billoo AG, Memon MA, Khaskheli SA, et al. Role of a probiotic (Saccharomyces boulardii) in management and prevention of diarrhoea. World Journal of Gastroenterology. 2006;12(28):4557-4560. doi:10.3748/wjg.v12.i28.4557
  • 22 . Szajewska H, Kołodziej M, Zalewski BM. Systematic review with meta-analysis: Saccharomyces boulardii for treating acute gastroenteritis in children—a 2020 update. Aliment Pharmacol Ther. 2020;51:678–688
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