Questions from readers: Is one probiotic better than another?

With so many different probiotics on the market, it’s hard to know which ones to use and when to use them. They’re commonly promoted as agents to help strengthen the immune system or recolonize the GI tract with “good bacteria.” Probiotics are found in foods, dietary supplements, infant formulas, and medical foods with strain compositions, doses, and storage requirements that vary widely among products. Since the evidence for various indications is formula-specific (genus, species, strain, number of live bacteria present, blend of probiotic strains, non-active ingredients) and the commercial availability is constantly changing it can be challenging to be sure you’re choosing the right probiotic for your patients, especially in a field that’s still evolving.

The Clinical Guide to Probiotic Products is a tool that can make probiotic selection easier for clinicians – helping them identify the right product, formulation, dose, and indications for use (Figure 1). The focus of content on the Probiotic Chart can be narrowed to adult health, women’s health, and pediatric health and products can be filtered by indication (Table 1). While the Clinical Guide is a helpful one-stop shop for probiotic evidence, users are encouraged to review the publications cited for each product and to consider patient population characteristics and study results to guide clinical decision-making.

Figure 1. Screenshot from the Clinical Guide to Probitoic Products Available in USA (

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Table 1. Indications for Probiotic Use (


About the Clinical Guide to Probiotic Products:

The Probiotic Chart Initiative was started in 2008 with the aim of providing information about available probiotics to Canadian healthcare providers. The Clinical Guide to Probiotic Products, a short summary of evidence linking probiotics to indications for use, was developed and distributed as continuing medical education (CME). Due to an overwhelming response to the materials and the demand for updated references, the Clinical Guide is reviewed and updated annually by a group of expert reviewers and opinion leaders in the field of probiotics known as the Alliance for Education on Probiotics (AEProbio) Scientific Advisory Working Group (SAWG). Despite its beginnings as a reference for probiotics sold in Canada, a version dedicated to products marketed in the US was developed and is available as a printed booklet, an app for download, or on the web at