Microbiological therapy

In 1908, Nobel Prize laureate Ilya Ilyich Mechnikov described a life-prolonging effect caused by the microorganisms found in fermented dairy products. In 1965, Daniel M. Lilly and Rosalie H. Stillwell coined the term “probiotic” as the antonym of “antibiotic.” In 1989, Fuller defined probiotics as “live microbial feed or food supplements that have a beneficial effect on the host organism by improving its intestinal microflora.” Since then, the FAO (Food and Agriculture Organization) and the WHO have endorsed this definition. 

Treatment with probiotics and prebiotics, or symbiotics, in conjunction with dietary adjustments that include minerals and vitamins, following a diagnostic stool examination. Postbiotics are also being used in the meantime. See also “Fecal Microbiota Transplantation.” 

Administration of microorganisms, bacteria, viruses, fungi, and their components or metabolic products. These were already used in the 19th century to boost the immune system. After this therapy had fallen into obscurity, it was initially used in complementary medicine as a form of symbiotic regulation. Since then, therapy with probiotics, prebiotics, and synbiotics has become established in many areas of medicine and is supported by scientific studies.

Indications include, for example, gastrointestinal disorders such as ulcerative colitis and irritable bowel syndrome; due to its immunomodulatory effects, it is also used for allergic conditions or other chronic diseases; when applied topically, it is used for the vaginal flora; and currently, it is also used externally in dermatology, for example, to treat atopic dermatitis, hay fever, asthma, food allergies, infectious diseases (vaginal, urological, dermatological),lactose intolerance, and rheumatic conditions. 

Studies on insulin resistance, diabetes mellitus, and Alzheimer’s disease and depression show the concurrent presence of dysbiosis. Initial results point to the potential for microbiological therapy in these conditions.

Caution: Autoimmune diseases, unexplained fever, immunodeficiencies

Among the numerous probiotics on the market, some are officially approved as drugs by the Federal Institute for Drugs and Medical Devices (BfArM): 

- Escherichia coli strain Nissle 1917, such as^Mutaflor®. Approved for maintaining remission in ulcerative colitis, including in cases of chronic constipation. Health insurance plans cover Mutaflor for the treatment ofulcerative colitis.

-Saccharomyces boulardii (yeast): Product, e.g.^{, Perenterol®.} Approved for the treatment and prevention of acute diarrhea (while traveling or during antibiotic therapy).

-Escherichia coli (other strains): Preparations such as^Symbioflor® 2, approved for the treatment of irritable bowel syndrome.

- Lactobacillus acidophilus:^Paidoflor®, e.g., after antibiotic therapy

- Lactobacillus gasseri & Bifidobacterium longum: Omniflora® N: for acute diarrhea

- Lactobacillus gasseri, and Lactobacillus rhamnosus:^Vagisan® Probio Flora supplementvaginal capsules following antibiotic treatment for bacterial vaginosis

The Federal Center for Nutrition lists the following substances as effective prebiotics:

Inulin and oligofructose (from chicory, Jerusalem artichokes, or onions).

Galactooligosaccharides: found in dairy products or legumes.

Resistant starch: found in cooked potatoes, rice, or pasta after they have cooled.

1. https://www.internisten-im-netz.de/fachgebiete/komplementaermedizin/naturheilkundliche-alternative-verfahren/mikrobiologische-therapie.html
2. https://www.aerzteblatt.de/archiv/45953/Probiotika-Praebiotika-und-Synbiotika-Stellenwert-in-Klinik-und-Praxis
3. https://www.bzfe.de/presse/pressemeldungen-archiv-2024-und-frueher/praebiotika-probiotika-postbiotika
4. Radke M (2013) Probiotics and Prebiotics. Pediatric GI, or PGHN (; 625–34. German. doi: 10.1007/978-3-642-24710-1_30. PMCID: PMC7498783
5. FAO/WHO (2001) Joint FAO/WHO Expert Consultation on the Evaluation of Health and Nutritional Properties of Probiotics in Food, Including Powdered Milk with Live Lactic Acid Bacteria. https://openknowledge.fao.org/server/api/core/bitstreams/382476b3-4d54-4175-803f-2f26f3526256/content
6. Lilly DM et al. (1965). Probiotics: Growth-promoting factors produced by microorganisms. Science, 147(3659), 747–748. doi.org

7. Metchnikoff, É. (1907). The Prolongation of Life: Optimistic Studies (trans. P. C. Mitchell). G. P. Putnam's Sons.