Probiotic Use of Lactobacillus rhamnosus and Lactobacillus acidophilus

Clinical Applications and Efficacy

Lactobacillus rhamnosus is more effective for preventing antibiotic-associated diarrhea, Clostridium difficile infection, and necrotizing enterocolitis in preterm infants, while Lactobacillus acidophilus shows greater efficacy in reducing total and LDL cholesterol levels 1, 2
The American Gastroenterological Association recommends Lactobacillus rhamnosus for preventing and treating diarrheal conditions, particularly antibiotic-associated diarrhea at doses of >10^9 CFU/day 2, 3
Lactobacillus rhamnosus is recommended for prevention of nosocomial diarrhea in pediatric populations 3
Lactobacillus rhamnosus demonstrates efficacy in preventing necrotizing enterocolitis in preterm infants, with significant reduction in all-cause mortality (OR 0.56, 95% CI 0.39-0.80) 4, 5
Lactobacillus acidophilus has superior efficacy in reducing total and LDL cholesterol compared to other Lactobacillus species 1
Lactobacillus acidophilus is often used in combination with other strains for metabolic conditions 1
Combination of Lactobacillus acidophilus and Bifidobacterium species is effective for prevention of necrotizing enterocolitis in preterm infants 4, 5

For antibiotic-associated diarrhea prevention, the American College of Gastroenterology recommends choosing Lactobacillus rhamnosus GG at doses >10^9 CFU/day 2, 3
For cholesterol management, Lactobacillus acidophilus is the preferred choice 1
For necrotizing enterocolitis prevention in preterm infants, the American Academy of Pediatrics recommends using combinations including both Lactobacillus rhamnosus and Lactobacillus acidophilus with Bifidobacterium species 4, 5

Strain specificity is crucial, with effects being strain-specific rather than species-wide 6
The American Gastroenterological Association recommends specific strains for specific conditions rather than making general recommendations about probiotics 5
The safety profile is generally excellent for both species, but caution is advised in premature neonates, immunocompromised patients, critically ill patients, and those with central venous catheters, cardiac valvular disease, or short-gut syndrome 3