Saccharomyces Boulardii for Fungal Infection Resistance
S. boulardii is itself a yeast, and it competes with Candida in the gut, with reasonable evidence for reducing colonisation.
Overview
Verdict
Better evidence than most antifungal botanicals, particularly around antibiotic use.
How It Works
Dosing & Protocol
Typical dose
- Recommended dose
- 250-500 mg (5-10 billion CFU) once or twice daily
- Expected timeframe
- 4-8 weeks
Protocol
- form
- Saccharomyces boulardii CNCM I-745; a yeast, so unaffected by antibacterial antibiotics but inactivated by antifungal drugs
- duration
- 2-4 weeks
- co factor
- Evidence is mixed. In vitro and animal work is reasonably consistent: S. boulardii inhibits Candida albicans adhesion to intestinal epithelium, suppresses hyphal transition and biofilm formation, and reduces Candida translocation in animal models, with capric acid among the proposed active components. Human data are limited to reduced Candida colonisation in specific clinical populations such as preterm infants and critically ill patients - and the latter group is one in which S. boulardii itself is contraindicated. No trial has shown reduced fungal infection incidence in healthy adults, and colonisation is not infection.
- titration
- Up to 500 mg twice daily; 1,000 mg/day is the usual upper dose in trials
- starting dose
- 250 mg twice daily if used, with or without food
Evidence
What the studies say
Probiotics for vulvovaginal candidiasis in non-pregnant women
Xie HY, Feng D, Wei DM
Probiotic adjuncts, including yeast and lactobacillus preparations, showed low-certainty benefit in candidiasis.
Prophylactic Saccharomyces boulardii versus nystatin for the prevention of fungal colonization and invasive fungal infection in premature infants
Saccharomyces boulardii was compared with nystatin for prevention of fungal colonization and invasive fungal infection in premature infants.
Safety
Caveats
Should not be used in immunocompromised patients or those with central venous catheters, where fungaemia has been reported.
Less likely to help if
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