This paper describes the consensus opinion of the participants in the 4th Triennial Yale/Harvard Workshop on Probiotic Recommendations. The recommendations update those of the first 3 meetings that were published in 2006, 2008, and 2011. Recommendations for the use of probiotics in necrotizing enterocolitis, childhood diarrhea, inflammatory bowel disease, irritable bowel syndrome and Clostridium difficile diarrhea are reviewed. In addition, we have added recommendations for liver disease for the first time. As in previous publications, the recommendations are given as A, B, or C ratings.
*Department of Internal Medicine, Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT
†Harvard Medical School
‡Mucosal Immunology and Biology Research Center, Massachusetts General Hospital for Children, Boston
††Department of Transplantation, Lahey Hospital and Medical Center, Burlington, MA
§Dairy & Food Culture Technologies, International Scientific Association of Probiotics and Prebiotics (ISAPP), Sacramento
**Department of Medicine, University of California, San Diego, San Diego, CA
∥Departments of Internal Medicine, Academic Medical Center and VUmC, Amsterdam, The Netherlands
¶Wallenberg Laboratory, Gothenborg University, Gothenburg, Sweden
#Minnesota Gastroenterology P.A., Minnesota, MN
‡‡Pediatric Liver & Liver Transplant, Gastroenterology/Transplantation, Phoenix Children’s Hospital
∥∥Mayo Clinic, Phoenix
§§Department of Pediatrics, University of Arizona, Tucson, AZ
¶¶Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples
##Clinical Hepato-Gastroenterology Unit, Division of Gastroenterology & Digestive Endoscopy, S. Raffaele University Hospital, Milano, Italy
***Division of Gastroenterology, University of Alberta, Edmonton, AB, Canada
†††Department of Gastroenterology, University of North Carolina School of Medicine, Chapel Hill, NC
‡‡‡The Lynda K. and David M. Underwood Center for Digestive Disorders, Houston Methodist Hospital, Houston, TX
§§§Department of Medicine, Weill Cornell Medical College, New York
∥∥∥Department of Medicine and Surgery, Division of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
M.H.F. is on the Scientific Advisory Committee (SAC) of Nature’s Bounty and was previously on the Medical Board of Dannon. W.A.W. is supported by NIH grants (P30 DK040561, P01 DK033506, R01 HD012437, R01 HD059126, 3T32DK007191-39S1). The other authors declare that they have nothing to disclose.
Reprints: Martin H. Floch, MD, Department of Internal Medicine, Section of Digestive Diseases, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT 06510 (e-mail: firstname.lastname@example.org).