Probiotics

Mechanism of Action

Although the complete mechanism of action probiotics have on the body is not fully understood, there have been certain notable findings in the past. Research has found probiotics to enhance the immune system, playing a role in both innate and adaptive immunity and increasing the overall efficiency. Furthermore, research shows that probiotics carry many anti-inflammatory effects. They act as a regulatory substance for the immune system, helping to sustain homeostasis when it comes to inflammatory and anti-inflammatory responses.[6] Probiotics have also been implicated in impacting both the enteric and central nervous systems, thereby decreasing notions of pain through the activation of opioid and endocannabinoid receptors.[7]

Administration

Probiotics come in a variety of different forms. They are available in fermented foods, capsules, liquids, and powders.[7] They are easily accessible and located in most grocery stores, pharmacies, and through online purchases.[7] With the easy accessibility of probiotics, sellers must be informed about the benefits of supplementation to provide better information to consumers.

Adverse Effects

There has been insufficient evidence on whether probiotics are safe or not. There have been rare occurrences where patients who took probiotics were subject to fungemia, bacteremia, and endocarditis. Research has revealed the most documented probiotics to cause fungemia to be Saccharomyces cerevisiae and Saccharomyces boulardii. Studies also show that bacteremia and sepsis resulted from various Lactobacillus strains, S. boulardii, S. cerevisiae, Bacillus subtilis, and Bifidobacterium breve. Endocarditis caused by probiotics is on record to be caused by Lactobacillus and Streptococcus.[5]

Contraindications

Generally, since most research indicates that probiotics are safe, there are no real contraindications. Instead, following the rare occurrences, specific individuals should proceed with caution. Those with short gut syndrome, the immunocompromised, and the elderly patients should consider potential side effects before initiation.[8] Furthermore, when placing central venous catheters, a proper protocol should be enforced to prevent the introduction of pathogens. 

Enhancing Healthcare Team Outcomes

A variety of probiotic strains have implications for use in various ailments. Identifying the strains that produce the most beneficial results is crucial to create a proper treatment regimen for potential patients. Probiotics can alleviate several different problems, which are only effective when adequately implemented.[9] 

Not only should clinicians be aware of the possible beneficial outcomes, but other health care professionals, such as nurses and pharmacists, should also be involved, working together as an interprofessional team. Although clinicians are the most influential in this matter, as they are usually the ones to advise patients on what to do next regarding specific disease processes, nurses are also crucial to this team. They can explain the use of this treatment regime while also monitoring the patient's vitals and potential side effects. Furthermore, pharmacists should be knowledgeable in regards to the patient's history and use of probiotics to ensure proper usage and provide efficient guidance. Now that probiotics are readily available in stores and online, the general public (as in the sellers and consumers) must also be aware of the uses and potential side effects. Therefore, to ensure the best possible outcomes for patients, the interprofessional group should be assembled to create a strategic plan for each person. When working as a group to assure excellent patient care and outcome, more patients will be able to attain the adequate care they require. [Level 5]

Studies indicate that most health care providers only have a medium level of expertise on probiotics, displaying the need for increased awareness and education. Since probiotics can treat a wide variety of diseases, it is crucial to better understand the topic to provide the best care to future patients.[10] As of now, there are no standard guidelines for prescribing probiotics, displaying the need for more significant research on this topic since it proves to have many potential health benefits.