What is the Probiotic Guide

Probiotics are similar to medications. When taken appropriately, they can resolve health problems and help us feel better. However, taking the wrong medication will not achieve the desired result. As each probiotic strain is unique and has a specific intended purpose, it must be selected carefully. Not all probiotics are suitable for treating all health issues, similar to medications. For example, just as you wouldn't take pain medication to prevent pregnancy, you would not substitute a probiotic for irritable bowel syndrome (IBS) with one used to relieve a baby’s colic.
Probiotics are largely unregulated, and it's essential to be cautious. Anyone can make claims about probiotic products without scientific evidence to support their safety and effectiveness. Choosing an unproven or incorrect probiotic for the condition you are trying to resolve may lead to the probiotic not working, resulting in wasted money and continued illness. This underscores the importance of being aware and cautious when selecting probiotics.

The demand for effective probiotic products is growing quickly as people seek safe and reliable options to resolve health challenges and feel better. It is essential to know the facts.
The good news is that there is strong scientific evidence supporting the use of specific probiotic strains and products for various conditions.

Since 2008, the Alliance for Education on Probiotics (AEProbio) has enlisted a committee of independent experts to conduct an extensive, systematic review of the literature to evaluate the latest research and provide an unbiased summary of the scientific evidence for specific probiotics.
The Clinical Guide to Probiotic Products summarizes and lists probiotics backed by scientific evidence. It is conveniently organized by condition, provides the probiotic strain designation, outlines the recommended dosage, proposes the reason for use and lists the relevant studies.

Summary of the Science Supporting The Guide

The good news is that there is now strong scientific evidence that supports the use of specific probiotic products for various conditions. Each year since 2008, the Alliance for Education on Probiotics (AEProbio) enlists a committee of independent experts to conduct an extensive, systematic review of the literature to evaluate and provide an unbiased summary of the scientific evidence for specific brands of probiotics.

To be considered for inclusion in The Guide, each product must be:

  • commercially available in Canada or the US as a supplement or probiotic-containing food
  • generally recognized as safe status (FDA) and/or Natural Product Number (Health Canada) for probiotic strain(s) used in the products
  • supported by favorable, published clinical evidence for the specific strain(s) listed in each product
  • supported by evidence for the specified combination of strains for products containing multiple strains

Note: Inclusion in the Guide is not influenced by or limited to members of AEProbio.

Levels of Evidence

Each product listed in The Guide is carefully reviewed by a team of probiotic experts and assigned a level of evidence (I, II or III with I being the highest level).

Level I
Evidence obtained from at least one appropriately designed trial, (e.g., randomization, blinding, appropriate population comparisons) with a power calculation for the outcome(s) of interest. The expert review board reserves the right to make the final decision for the level of recommendation.
Level II
Evidence obtained from well-designed controlled trials without randomization; evidence obtained from randomized trials not satisfying all criteria listed in Level I. Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group. Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled trials might also be regarded as this type of evidence
Level III
Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees

Conditions The Guide Covers

The Guide currently examines and lists probiotics supported by scientific evidence for the following conditions.

  • Antibiotic-Associated Diarrhea
  • Bacterial Vaginosis
  • Constipation
  • Clostridium Difficile Associated Diarrhea (prevention)
  • Childhood Eczema / Atopic Dermatitis
  • Common Infectious Disease – community acquired
  • Cow Milk Protein Allergy (CMAP)
  • Colic
  • Functional Abdominal Pain
  • Helicobacter Pylori – as adjunct to standard eradication therapy
  • Inflammatory Bowel Disease – Pouchitis
  • Inflammatory Bowel Disease
  • Irritable Bowel Syndrome (IBS)
  • Infectious Diarrhea
  • Liver Health
  • Mood and Affect
  • Necrotizing Enterocolitis (in newborns) * as per hospital protocol, not for self-administration
  • Nosocomial Infections (prevention)
  • Oral Health (reduction of tonsillitis, laryngitis, dental caries)
  • Regurgitation / Improves gastrointestinal motility
  • Traveler’s Diarrhea – prevention
  • Vulvovaginal Candidiasis

Product Review Process

The Clinical Guide to Probiotic Products has been translating the scientific evidence available for probiotic products into practical, clinically-relevant information since 2008. This trusted resource is intended to be used as a clinical decision-making tool, enabling health care providers to easily select the appropriate product, dose, and formulation for a specific indication.

A systematic literature review using pre-defined inclusion criteria was undertaken to identify studies of defined clinical outcomes for specific probiotic strain(s). Commercially available products containing said strain(s) were identified, and the levels of evidence were used to rate the strength of expected benefit. This information was compiled into a chart format. Data were assessed by a group of independent expert reviewers.
In the case of probiotics, the clinical evidence must be linked to specific formulations as defined by genus, species, alphanumeric designation or strain, number of live bacteria present, the blend of probiotic strains present and finally, non-active ingredients present.
Every attempt was made by the author and reviewers to include the published clinical data for the available probiotic formulations. To avoid selection bias toward any specific formulation, we have conducted a literature search of two databases (PubMed, EMBASE) and contacted our independent experts to identify any published or unpublished studies. Our aim is to ensure that the appropriate product/strain is selected for the desired outcome. This Clinical Guide is not meant to be interpreted as a systematic review, or a “clinical practice guideline”, nor is it an endorsement for companies to market health claims.

Each brand is listed with the condition it can impact (listed to the right), the strain(s) of probiotics it contains, what form it is available in, the colony-forming units (CFUs) per dose, and the level of scientific evidence available with direct references to the related studies. The Guide also notes products that are gluten-free and needing refrigeration.

To apply to have a product listed in the Guide, please complete the Product Review Request Form

Areas of Health

The Guide is broken into four main areas:

  • Adult Health
  • Pediatric Health
  • Vaginal Health
  • Functional Foods with Added Probiotics

The Expert Review Committee

Our distinguished Expert Review Committee is composed of leaders from across the globe. Every year, they meticulously and impartially review the available scientific evidence on the safety and efficacy of specific probiotic products. The annual updates for the Clinical Guide to Probiotic Products, which include the latest published evidence and a listing of products meeting their rigorous review criteria, are a valuable resource for anyone seeking reliable information on probiotics.

Get the Probiotic Guide

The Clinical Guide to Probiotic Products is available in two regions: Canada and the USA.
The content is updated annually following the independent expert review and is easily accessible through a variety of media, empowering you with the latest information. Please see the links below for access to the online versions (interactive websites or mobile apps) and the booklet version (printable PDF).

Canada
USA
United Kingdom

Online

www.probioticchart.ca
www.usprobioticguide.com
www.probioticguide.uk

Mobile App

PDF Booklet

English

French