Saccharomyces boulardii for Antibiotic-Associated Diarrhea (AAD)
AMultiple meta-analyses show S. boulardii reduces AAD risk by 47-53% (RR 0.47). Most studied probiotic for AAD prevention with consistent positive results across antibiotic classes.
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A
The Bottom Line
Multiple meta-analyses show S. boulardii reduces AAD risk by 47-53% (RR 0.47). Most studied probiotic for AAD prevention with consistent positive results across antibiotic classes.
Key Study Findings
Review
The evidence for probiotics in the treatment of digestive disorders in the pediatric population.
Dose: None
vs: None
Outcome: None
Effect: None
None
Population: Pediatric population
Review
Intestinal Dysbiosis: Exploring Definition, Associated Symptoms, and Perspectives for a Comprehensive Understanding - a Scoping …
Dose: None
vs: None
Outcome: None
Effect: None
None
Population: scoping review of intestinal dysbiosis definition, symptoms, and probiotic adjuvant therapy in adults and children
Other
Ibero-Latin American clinical practice guideline for the use of biotics in pediatric gastroenterology, hepatology, and …
Dose: None
vs: None
Outcome: Clinical guideline recommendations for pediatric GI
Effect: None
None
Population: Pediatric patients with GI disorders
Observational Study
n=279
Use of Probiotics During Antibiotic Therapy in Pediatrics: A Cross-Sectional Survey of Italian Primary Care …
Dose: None
vs: None
Outcome: Probiotic prescribing habits of Italian PCPs
Effect: L. rhamnosus GG used by 91.8%
None
Population: Italian primary care pediatricians
Randomized Controlled Trial
n=564
20 weeks
Double-blind
High-dose Probiotic Mix of Lactobacillus spp., Bifidobacterium spp., Bacillus coagulans, and Saccharomyces boulardii to Prevent …
Dose: None
vs: Placebo
Outcome: Quality of life
Effect: None
P < .001
Population: None
Review
Clostridioides difficile Infections: Prevention and Treatment Strategies.
Dose: None
vs: None
Outcome: C. difficile infection treatment outcomes
Effect: None
None
Population: Patients with C. difficile infection
Key Statistics
25
Studies
5000
Participants
↑
Positive
A
Grade
Referenced Papers
Probiotics and antimicrobial …
2025
26 citations
The evidence for probiotics in the treatment of digestive disorders in the pediatric population.
Review
Journal of gastroenterology …
2025
10 citations
Antibiotics (Basel, Switzerland)
2025
Boletin medico del …
2025
Open forum infectious …
2024
7 citations
Zhongguo dang dai …
2024
5 citations
Advances in experimental …
2024
2 citations
Therapeutic advances in …
2023
97 citations
Overview of systematic reviews of probiotics in the prevention and treatment of antibiotic-associated diarrhea in children.
Systematic Review
Frontiers in pharmacology
2023
20 citations
Cureus
2023
19 citations
Cureus
2023
5 citations
The Journal of …
2023
1 citations
Archivos argentinos de …
2022
23 citations
Diversity of Saccharomyces boulardii CNCM I-745 mechanisms of action against intestinal infections.
Review
World journal of …
2019
92 citations
Advances in experimental …
2019
17 citations
Frontiers in medicine
2018
450 citations
Choosing an appropriate probiotic product for your patient: An evidence-based practical guide.
Systematic Review
PloS one
2018
205 citations
Pharmacological research
2018
132 citations
World journal of …
2018
52 citations
The American journal …
2018
46 citations
World journal of …
2017
68 citations
Journal of pediatric …
2016
233 citations
Clinical and experimental …
2016
82 citations
Open forum infectious …
2016
58 citations
Digestive diseases (Basel, …
2016
37 citations
The Cochrane database …
2015
233 citations
Antibiotics (Basel, Switzerland)
2015
104 citations
Journal of clinical …
2015
35 citations
Bugs and Guts: Practical Applications of Probiotics for Gastrointestinal Disorders in Children.
Review
Nutrition in clinical …
2015
31 citations
Nutricion hospitalaria
2015
5 citations
MMW Fortschritte der …
2014
14 citations
MMW Fortschritte der …
2014
3 citations
Expert opinion on …
2014
The American journal …
2012
104 citations
Saccharomyces boulardii and antibiotic-associated diarrhea: effectiveness of prophylactic use.
Other
The American journal …
2012
5 citations
Medycyna wieku rozwojowego
2012
1 citations
Journal of clinical …
2011
432 citations
World journal of …
2010
512 citations
Journal for specialists …
2010
22 citations
Probiotics.
Review
American journal of …
2010
European journal of …
2009
91 citations
Current opinion in …
2009
82 citations
Advances in biochemical …
2008
535 citations
Journal of clinical …
2008
Probiotics.
Review
American family physician
2008
The Journal of …
2007
265 citations
The Cochrane database …
2007
The American journal …
2006
918 citations
Probiotics for pediatric antibiotic-associated diarrhea: a meta-analysis of randomized placebo-controlled trials.
Meta-Analysis
CMAJ : Canadian …
2006
197 citations
Probiotics for the prevention of antibiotic-associated diarrhea and Clostridium difficile diarrhea.
Review
Journal of clinical …
2006
112 citations
Medical science monitor …
2006
The American journal …
2001
648 citations
International journal of …
2000
181 citations
Clinical infectious diseases …
1998
346 citations
Anaerobe
1997
40 citations
Gastroenterology
1989
418 citations
Dosage & Usage
mg = milligrams · mcg = micrograms (1,000× smaller) · IU = International Units
Commonly Used Dosages
- general:
- 250-500 mg/day (equivalent to 5-10 billion CFU)
- aadprevention:
- 500 mg/day (start with antibiotic, continue 7 days after)
- cdiffprevention:
- 500 mg twice daily as adjunct to standard therapy
- travelersdiarrhea:
- 250-500 mg/day starting 5 days before travel
Upper limit: Well-tolerated up to 1,000 mg/day in clinical trials
Dosages Studied in Research
| Dosage | Duration | Effect | N |
|---|---|---|---|
| None | -- | Mixed | -- |
| None | -- | Positive | -- |
| None | -- | Positive | -- |
| None | -- | Mixed | 279 |
| None | 20 weeks | Positive | 564 |
| None | -- | Positive | -- |
| None | 1 weeks | Positive | 47 |
| Various probiotic interventions | -- | Positive | -- |
Best taken: Can be taken with or without food; space 2 hours from antifungals
Safety & Side Effects
Reported Side Effects
- ⚠ Mild gas and bloating
- ⚠ Rare: fungemia in critically ill patients with central venous catheters
- ⚠ Thirst (yeast may increase water requirements)
- ⚠ Very rare: potential environmental contamination risk in ICU settings
Known Interactions
- ● Antifungal medications (may kill S. boulardii, reducing effectiveness)
- ● Monoamine oxidase inhibitors (S. boulardii contains tyramine)
- ● Immunosuppressants (theoretical risk of fungemia in immunocompromised patients)
Tolerable upper intake: Well-tolerated up to 1,000 mg/day in clinical trials
Always consult your healthcare provider before starting any supplement.
Frequently Asked Questions
Does Saccharomyces boulardii help with Antibiotic-Associated Diarrhea (AAD)?
Based on 25 studies with 5,000 participants, there is strong evidence from multiple clinical trials that Saccharomyces boulardii may support Antibiotic-Associated Diarrhea (AAD) management. Our evidence grade is A (Strong Evidence).
How much Saccharomyces boulardii should I take for Antibiotic-Associated Diarrhea (AAD)?
Studies have used various dosages. A commonly studied range is 250-500 mg/day (equivalent to 5-10 billion CFU). Always consult your healthcare provider before starting any supplement regimen.
Are there side effects of Saccharomyces boulardii?
Reported side effects may include Mild gas and bloating, Rare: fungemia in critically ill patients with central venous catheters, Thirst (yeast may increase water requirements), Very rare: potential environmental contamination risk in ICU settings. Most side effects are mild and dose-dependent. Consult your doctor if you experience any adverse reactions.
How strong is the evidence for Saccharomyces boulardii and Antibiotic-Associated Diarrhea (AAD)?
We rate the evidence as Grade A (Strong Evidence). This rating is based on 25 peer-reviewed studies with 5,000 total participants. The overall direction of effect is positive.
Related Evidence
Other ingredients for Antibiotic-Associated Diarrhea (AAD)
Saccharomyces boulardii for other conditions
FDA Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The products and information on this website are not intended to diagnose, treat, cure, or prevent any disease. The evidence grades presented are based on our analysis of published peer-reviewed research and do not constitute medical advice. Always consult your healthcare provider before starting any supplement regimen.