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Saccharomyces boulardii for Clostridioides difficile Infection (CDI)

B

Meta-analyses show S. boulardii reduces CDI recurrence by 50-60% when given as adjunct to standard antibiotic treatment. Strongest evidence for preventing recurrent CDI.

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B

The Bottom Line

Meta-analyses show S. boulardii reduces CDI recurrence by 50-60% when given as adjunct to standard antibiotic treatment. Strongest evidence for preventing recurrent CDI.

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
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

Review 520 weeks
Qualitative Analysis of the Efficacy of Probiotic Strains in the Prevention of Antibiotic-Associated Diarrhea.
Dose: None vs: None Outcome: None Effect: None None

Population: None

Review
Clostridium difficile Colitis Prevention and Treatment.
Dose: None vs: None Outcome: Diarrhea outcomes Effect: None None

Population: None

Systematic Review n=228
Strain-Specificity and Disease-Specificity of Probiotic Efficacy: A Systematic Review and Meta-Analysis.
Dose: None vs: None Outcome: Diarrhea outcomes Effect: None None

Population: None

Review
Probiotics in Gastroenterology: How Pro Is the Evidence in Adults?
Dose: None vs: None Outcome: GI condition outcomes (C. diff, AAD, H. pylori) Effect: None None

Population: Adults with GI conditions

Key Statistics

6

Studies

3000

Participants

Positive

B

Grade

Referenced Papers

Advances in experimental … 2024 2 citations
Advances in experimental … 2019 17 citations
The American journal … 2018 46 citations
Journal of pediatric … 2016 233 citations
Journal of clinical … 2011 432 citations
American journal of … 2010
Current opinion in … 2009 82 citations
The American journal … 2001 648 citations
International journal of … 2000 181 citations
Clinical infectious diseases … 1998 346 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 520 weeks Positive --
None -- Mixed --
None -- Mixed 228
None -- Mixed --
None -- Mixed --
None -- Mixed --

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 Clostridioides difficile Infection (CDI)?
Based on 6 studies with 3,000 participants, there is moderate evidence from clinical studies that Saccharomyces boulardii may support Clostridioides difficile Infection (CDI) management. Our evidence grade is B (Good Evidence).
How much Saccharomyces boulardii should I take for Clostridioides difficile Infection (CDI)?
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 Clostridioides difficile Infection (CDI)?
We rate the evidence as Grade B (Good Evidence). This rating is based on 6 peer-reviewed studies with 3,000 total participants. The overall direction of effect is positive.

Related Evidence

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.