Probiotics for Gastrointestinal Diseases Clinical Practice Guidelines (AGA, 2020)

American Gastroenterological Association

This is a quick summary of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

August 03, 2020

Guidelines on the role of probiotics in the management of gastrointestinal disorders were published in 2020 by the American Gastroenterological Association (AGA).[1]

In adults and children on antibiotic treatment, the AGA recommends the use of S boulardii; or the 2-strain combination of L acidophilus CL1285 and Lactobacillus casei LBC80R; or the 3-strain combination of L acidophilus, Lactobacillus delbrueckii subsp bulgaricus, and Bifidobacterium bifidum; or the 4-strain combination of L acidophilus, L delbrueckii subsp bulgaricus, B bifidum, and Streptococcus salivarius subsp thermophilus over no or other probiotics for prevention of C difficile infection.

In adults and children with pouchitis, the AGA recommends the 8-strain combination of L paracasei subsp paracasei DSM 24733, L plantarum DSM 24730, L acidophilus DSM 24735, L delbrueckii subsp bulgaricus DSM 24734, B longum subsp longum DSM 24736, B breve DSM 24732, B longum subsp infantis DSM 24737, and S salivarius subsp thermophilus DSM 24731 over no or other probiotics.

The AGA does not recommend the use of probiotics in children with acute infectious gastroenteritis.

In preterm (less than 37 weeks gestational age), low-birth-weight infants, the AGA recommends using a combination of Lactobacillus spp and Bifidobacterium spp (L rhamnosus ATCC 53103 and B longum subsp infantis; or L casei and B breve; or L rhamnosus, L acidophilus, L casei, B longum subsp infantis, B bifidum, and B longum subsp longum; or L acidophilus and B longum subsp infantis; or L acidophilus and B bifidum; or L rhamnosus ATCC 53103 and B longum Reuter ATCC BAA-999; or L acidophilus, B bifidum, B animalis subsp lactis, and B longum subsp longum), or B animalis subsp lactis (including DSM 15954), or L reuteri (DSM 17938 or ATCC 55730), or L rhamnosus (ATCC 53103 or ATC A07FA or LCR 35) for prevention of necrotizing enterocolitis (NEC) over no and other probiotics.

For more Clinical Practice Guidelines, go to Guidelines.

For more information, go to Pediatric Gastroenteritis.

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