Synopsis

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

Lactobacillus bulgaricus is a probiotic bacterium commonly used in the fermentation of yogurt and other dairy products. Its use as an adjunct to antibiotics is supported by some scientific evidence, though the quality and quantity of this evidence are moderate at best. Probiotics, including L. bulgaricus, have been studied for their ability to restore and maintain gut microbiota disrupted by antibiotic therapy, thereby reducing the risk of antibiotic-associated diarrhea (AAD) and Clostridioides difficile infections. Several clinical trials and meta-analyses suggest that probiotic mixtures containing L. bulgaricus can decrease the incidence and severity of AAD, especially in children and adults undergoing antibiotic treatment. The mechanism is thought to involve competitive inhibition of pathogenic bacteria, enhancement of mucosal barrier function, and modulation of the host immune response.

However, it is important to note that while L. bulgaricus is often included in probiotic formulations, it is rarely used alone and the evidence specifically for L. bulgaricus (as opposed to other Lactobacillus or Bifidobacterium strains) is limited. Most clinical studies use multi-strain combinations, making it difficult to attribute benefits solely to L. bulgaricus. There is little to no evidence supporting the use of L. bulgaricus as a direct alternative to antibiotics for treating infections. Instead, its role is mainly supportive—helping to mitigate adverse effects associated with antibiotic use rather than replacing antibiotics themselves.

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