CASE STUDY
www.culturellehcp.com
bacterial families within a day of being admitted. “We saw incredible growth of pathogenic
bacteria that would just take over the gut and cause severe infection.”
PROBIOTICS IN ACTION TODAY
In his practice, Dr. John Damianos, M.D., Internal Medicine at Yale New Haven Hospital, works in
inpatient and outpatient environments. He recommends probiotics for people taking a course of
antibiotics, as many physicians do today, and for other GI-related issues such as irritable bowel
syndrome, functional dyspepsia, pouchitis, and more. He says there's also developing evidence
that probiotics can increase the likelihood of Helicobacter pylori eradication when combined with
the current standard of care of either triple or quadruple therapy. “So there are really multiple
specific indications that I'm recommending probiotics for — but I'm not recommending taking any
probiotic off the shelf. I'm recommending specific strains or mixes of strains that specify doses
based on clinical trial data for people.”
Pauley regularly uses probiotics for babies with allergic colitis due to an allergy to cow's milk
or sometimes even breast milk. “I've also found probiotics useful in treating post-COVID and
other post-viral diarrhea that seems to linger,” she says. Beyond that, she notes there is growing
research that indicates probiotics can affect the immune system in a way that makes people less
prone to viral infections. “This seems to be especially true for people — like some of the children,
teenagers, and young adults I see — who don't have great diets or access to whole foods, so the
daily use of a probiotic is interesting to me in those cases.”
In addition to his role as a critical care physician, Wischmeyer is also the director of the nutrition
team at Duke University Hospital and associate vice chair for clinical research for the department
of anesthesiology. As a result, he spends about half his time researching nutrition, exercise,
probiotics, and microbiomes to help people prepare for surgery and bone marrow transplants to
lower the risk of pneumonia and hospital-acquired infections. “We know, for instance, probiotics
can reduce C. diff by as much as 70%.” This is important, he explains, because C. diff is one of the
fastest-growing iatrogenic diseases he sees today.
A large meta-analysis has also indicated that using a probiotic can reduce the risk of upper
respiratory infection by as much as 50%. This led Wischmeyer and his team to study the effect
of probiotics to help minimize the spread of COVID-19. Funded through the FDA's Investigational
New Drug (IND) program, the study used Culturelle® probiotics, delivering the probiotic strain
Lactobacillus rhamnosus GG. “Although the study was small, we had some encouraging signals,”
he says. “Our initial data showed that we could significantly reduce the symptoms from COVID-19
and the actual time to diagnosis.”
CHOOSING THE RIGHT PROBIOTIC
“The thing to understand is that not all probiotics are the same,” says Pauley. “You need to
know you're using the right one for the right condition.” And that, she says, comes down to
the data. Damianos, who serves on the Scientific Advisory Committee for the Alliance for
Education on Probiotics (AEProbio), an international organization focused on advancing the
science of probiotics, agrees. “One of the challenges in the field is that probiotics are considered
supplements, so they aren't regulated in the same way as medications.” Although there's a lot of
research and funding going into the field, there's a lot of misinformation out there as well. He says
this leads many people to write probiotics off as a class.
That's one of the reasons as part of his work with AEProbio, Damianos writes a quarterly
research review about the latest science as it pertains to probiotics. “I encourage people to
consider probiotics like any other medication.” He uses antibiotics as an example. “Doctors don't
“
“
I encourage
people to consider
probiotics like any
other medication.”
We know, for
instance, that
probiotics can
reduce C. diff by
as much as 70%.”
John Damianos, M.D.
Internal Medicine
~ Yale New Haven Hospital
Paul Wischmeyer, M.D.
Anesthesiologist, Critical
Care Specialist
~ Duke University Hospital