Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Enterococcus species, particularly Enterococcus faecium and Enterococcus faecalis, are used in some probiotic formulations and have been studied as alternatives or adjuncts to antibiotics, mainly for their ability to competitively inhibit pathogenic bacteria, modulate the gut microbiome, and produce bacteriocins (antimicrobial peptides). There is some scientific support, especially in veterinary medicine and animal husbandry, for the use of enterococci as alternatives to antibiotics for growth promotion and prevention of gastrointestinal infections. In humans, certain strains have been evaluated for their ability to reduce the incidence or duration of antibiotic-associated diarrhea and to restore gut microbiota after antibiotic use.

However, the overall quality of human clinical evidence is low to moderate, with most studies being small, heterogeneous, or of limited duration. Safety concerns also exist, as enterococci can be opportunistic pathogens and are associated with antibiotic resistance (e.g., vancomycin-resistant enterococci, VRE). Thus, while there is a scientific rationale and some experimental evidence, the use of Enterococcus species as antibiotic alternatives in humans is not widely endorsed, and regulatory authorities generally do not recommend their broad use for this purpose. The evidence is stronger in animals than in humans, and the risk-benefit profile in clinical use remains debated.

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