Postgrad Med J 80:516-526 doi:10.1136/pgmj.2003.008664
  • Review

Probiotics and human health: a clinical perspective

  1. H S Gill1,
  2. F Guarner2
  1. 1Primary Industries Research Victoria, Department of Primary Industries, Werribee, Victoria, Australia and Institute of Food, Nutrition and Human Health, Massey University, Palmerston North, New Zealand
  2. 2Digestive System Research Unit, University Hospital Vall d’Hebron, Barcelona, Spain
  1. Correspondence to:
 Professor Harsharnjit S Gill
 Primary Industries Research Victoria-Werribee Centre, Department of Primary Industries, 600 Sneydes Road, Werribee, VIC 3030, Australia;
  • Received 27 November 2003
  • Accepted 26 February 2004


There is unequivocal evidence that administration of probiotics could be effective in the treatment of acute infectious diarrhoea in children and the prevention of antibiotic associated diarrhoea and nosocomial/community acquired diarrhoea. Encouraging evidence is also emerging for the effectiveness of probiotics in the prevention and management of pouchitis and paediatric atopic diseases, and the prevention of postoperative infections. There is also strong evidence that certain probiotic strains are able to enhance immune function, especially in subjects with less than adequate immune function such as the elderly. Efficacy of probiotics in the prevention of traveller’s diarrhoea, sepsis associated with severe acute pancreatitis, and cancers, the management of ulcerative colitis, and lowering of blood cholesterol remains unproven. In addition to firm evidence of efficacy (for a range of conditions), major gaps exist in our knowledge regarding the mechanisms by which probiotics modulate various physiological functions and the optimum dose, frequency, and duration of treatment for different probiotic strains.