Probiotic therapy-part 2: clinical perspectives

In this second of a two-part series, the efficacy of probiotic treatment is discussed by a pediatric gastroenterologist and a compounding pharmacist, who, with patients and caregivers, have tailored many probiotic regimens to a successful outcome. Although the mechanisms of action for probiotics remain unclear, the benefits of probiotics therapy are being documented increasingly in case reports, research studies, and randomized controlled trials. Recommending treatment that is not helpful could, to a degree, be harmful, and thus published data should be reviewed when a probiiotic supplement is selected. Patients may require information on the therapeutic effectiveness and safety of probiiotics, and pharmacists should have such information available. Although there are manufactured probiotic supplements, innovative compounding enables pharmacists to offer their clients novel dosage forms. The future of probiotic therapy includes the possibility of genetically engineered probiotic bacterial strains that exert target effects in the gut and an increase in available probiotic formulations for compounding pharmacists to offer their clients.