Bacteria in Probiotics Carry Potential Risks for Immunocompromised Patients

Should patients receiving chemotherapy take probiotics? — Name withheld upon request

Probiotics are frequently used by people with and without cancer, typically to aid in digestive issues. These products contain multiple organisms, including the bacteria Lactobacillus, Streptococcus, Bifidobacterium, and the yeast Saccharomyces. There are some reports of patients developing infections after taking probiotics. Some of the patients in these reports were immunocompromised, including patients who were critically ill, had HIV/AIDS, or had previously undergone organ transplantation. Due to these reports, there is some concern that patients who are immunocompromised as a result of receiving chemotherapy may also be at risk of complications due to probiotic use.

At many institutions, patients receiving immunosuppressive chemotherapy are counseled to avoid probiotics during periods of myelosuppression. In addition, patients receiving chemotherapy or who have central venous catheters are advised to avoid the use of probiotics containing certain species of Saccharomyces. This recommendation is due to multiple reports of infections in patients taking probiotics with these ingredients. — Lisa A. Thompson, PharmD, BCOP