probiotic (Lacticaseibacillus rhamnosus)

Reported Uses

• NOTE: see Herb & Supplement Effectiveness Rating Definitions table
• abdominal pain [Insufficient Evidence]
• ADHD [Insufficient Evidence]
• allergic rhinitis [Insufficient Evidence]
• aphthous ulcer (canker sores) [Insufficient Evidence]
• atopic dermatitis (eczema) [Possibly Effective]
• atopic dz prevention [Possibly Effective]
• bacterial vaginosis [Insufficient Evidence]
• bipolar disorder [Insufficient Evidence]
• C. difficile infection prevention [Insufficient Evidence]
• cancer [Insufficient Evidence]
• candidiasis, oropharyngeal [Insufficient Evidence]
• candidiasis, vulvovaginal [Insufficient Evidence]
• child development [Insufficient Evidence]
• cognitive decline, age-related [Insufficient Evidence]
• cognitive function [Insufficient Evidence]
• cognitive impairment [Insufficient Evidence]
• colic [Insufficient Evidence]
• common cold [Insufficient Evidence]
• constipation [Insufficient Evidence]
• COVID-19 [Insufficient Evidence]
• critical illness (trauma) [Possibly Ineffective]
• Crohn dz [Insufficient Evidence]
• cystic fibrosis [Insufficient Evidence]
• dental caries prevention [Insufficient Evidence]
• dental plaque [Insufficient Evidence]
• denture stomatitis [Insufficient Evidence]
• diabetes [Insufficient Evidence]
• diarrhea [Insufficient Evidence]
• diarrhea, antibiotic-assoc. [Possibly Effective]
• diarrhea, chemo-related [Insufficient Evidence]
• diarrhea, malnourishment-related [Insufficient Evidence]
• diarrhea, rotaviral [Insufficient Evidence]
• gingivitis [Insufficient Evidence]
• group B streptococcal colonization [Insufficient Evidence]
• H. pylori infection [Insufficient Evidence]
• HIV/AIDS [Insufficient Evidence]
• HTN [Insufficient Evidence]
• hypercholesterolemia [Insufficient Evidence]
• IBS [Insufficient Evidence]
• lactose intolerance [Insufficient Evidence]
• malnutrition [Insufficient Evidence]
• metabolic syndrome [Insufficient Evidence]
• necrotizing enterocolitis [Insufficient Evidence]
• neurogenic bladder [Insufficient Evidence]
• nonalcoholic fatty liver dz [Insufficient Evidence]
• obesity [Insufficient Evidence]
• osteoarthritis [Insufficient Evidence]
• otitis media [Insufficient Evidence]
• peanut allergy [Possibly Ineffective]
• periodontitis [Insufficient Evidence]
• polycystic ovary syndrome [Insufficient Evidence]
• postop bowel function [Insufficient Evidence]
• postop infection [Insufficient Evidence]
• postop recovery [Insufficient Evidence]
• postpartum depression [Insufficient Evidence]
• pouchitis [Insufficient Evidence]
• respiratory infections [Insufficient Evidence]
• rheumatoid arthritis [Insufficient Evidence]
• short bowel syndrome [Insufficient Evidence]
• small intestinal bacterial overgrowth (SIBO) [Insufficient Evidence]
• stress [Insufficient Evidence]
• traveler's diarrhea prophylaxis [Insufficient Evidence]
• ulcerative colitis [Insufficient Evidence]
• UTI [Insufficient Evidence]
• ventilator-assoc. pneumonia prevention [Possibly Ineffective]

Reported Doses

Safety/efficacy may not be established; reported doses may be derived from limited or potentially inadequate studies w/ variable regimens, multi-ingredient products, or where concentration of active ingredients may vary widely

Special Note

[formulation clarification]

Info: uses and doses represent various probiotic-containing products; other Lacticaseibacillus species exist, but are not included; prior name was Lactobacillus rhamnosus, reclassified as Lacticaseibacillus; select proprietary products noted below

[Culturelle products]

Info: each capsule contains 10-20 billion CFUs L. rhamnosus GG; each chewable tablet contains 2.5-10 billion CFUs L. rhamnosus GG; each powder packet contains 2.5-5 billion CFUs L. rhamnosus GG; other multi-ingredient products exist

Effectiveness Ratings

[see Herb & Supplement Effectiveness Rating Definitions table]

atopic dermatitis (eczema) tx

[Possibly Effective]

Dose: 30 billion CFUs/kg/day PO qd in infants (L. rhamnosus GG); Alt: 1 billion CFUs PO qd in pts <2 yo (L. rhamnosus LOCK 0900 25%, LOCK 0908 25% plus other probiotics); 20 billion CFUs PO bid in pts 1-13 yo (L. rhamnosus 19070-2 plus other probiotics); 10 billion CFUs PO qd in pts 1-12 yo (L. rhamnosus IDCC 3201); 3 billion CFUs PO qd (L. rhamnosus LRH020 plus other probiotics); 10 billion CFUs PO qd in pts 6-36 mo (L. rhamnosus GG)

atopic dermatitis (eczema) prevention

[Possibly Effective]

Dose: 6 billion CFUs PO qd (L. rhamnosus HN001); Alt: 2 billion CFUs PO qd (L. rhamnosus GG plus other probiotics); 2 billion CFUs PO qd (L. rhamnosus LPR plus other probiotics); 105 billion CFUs PO qd (L. rhamnosus GG plus other probiotics); Info: may start tx in pregnant pts at 32-36 wk gestation, then cont. until 2-6mo postpartum, then may cont. 2-6 billion CFUs PO qd in infants x2-24 mo after birth

atopic dz prevention

[Possibly Effective]

Dose: 10-20 billion CFUs PO qd (L. rhamnosus GG); Alt: 6 billion CFUs PO qd (L. rhamnosus HN001); Info: for infants w/ family hx of atopy; start tx in pregnant pts 2-5wk before delivery, then cont. in infants x3-36 mo after birth

bacterial vaginosis

[Insufficient Evidence (PO route)]

Dose: 4 billion CFUs/day PO divided qd-bid (L. rhamnosus GR-1 plus other probiotics); Info: used w/ metronidazole or tinidazole

[Insufficient Evidence (PV route)]

Dose: 200 million-2 billion CFUs PV qd x10 days (L. rhamnosus Lbp PB01-DSM 14870 plus other probiotics); Start: after clindamycin 2% vaginal cream x7 days

bipolar disorder

[Insufficient Evidence]

Dose: 100 million CFUs PO qd (L. rhamnosus GG plus other probiotics)

C. difficile infection prevention

[Insufficient Evidence]

Dose: 50-100 billion CFUs PO qd x5 days (L. rhamnosus CLR2 plus other probiotics); Info: used w/ antibiotics

candidiasis, vulvovaginal

[Insufficient Evidence]

Dose: 1 billion CFUs supp PV bid x7 days (L. rhamnosus GG); Info: used w/ conventional tx

cognitive decline, age-related

[Insufficient Evidence]

Dose: 10 billion CFUs PO qd (L. rhamnosus GG)

cognitive impairment

[Insufficient Evidence]

Dose: 10 billion CFUs PO qd (L. rhamnosus GG)

colic

[Insufficient Evidence]

Dose: 250 million CFUs PO qd (L. rhamnosus plus other probiotics); Alt: 5 billion CFUs PO qd (L. rhamnosus ATCC 53103); Info: for infants 2-12 wk

dental caries prevention, adult pts

[Insufficient Evidence]

Dose: 200 million CFUs PO qd (L. rhamnosus LB21); Info: used w/ or w/o fluoride

dental caries prevention, peds pts

[Insufficient Evidence]

Dose: 21-292 million CFUs PO qd (L. rhamnosus GG ATCC 53103); Info: for pts 1-6 yo

dental plaque, adult pts

[Insufficient Evidence]

Dose: 4 billion CFUs lozenge PO qd (L. rhamnosus GG ATCC 53103 plus other probiotics)

dental plaque, peds pts

[Insufficient Evidence]

Dose: 1.84 billion CFUs lozenge PO bid (L. rhamnosus GG plus other probiotics); Info: for pts 13-15 yo

diabetes mellitus, type 2

[Insufficient Evidence]

Dose: 111 billion CFUs PO qd (L. rhamnosus plus other probiotics)

diarrhea prevention, peds pts

[Insufficient Evidence]

Dose: 6 billion CFUs PO bid in pts 1-36 mo (L. rhamnosus GG); Alt: 37 billion CFUs PO qd in pts 6-24 mo (L. rhamnosus GG)

diarrhea, antibiotic-assoc., adult pts

[Possibly Effective]

Dose: 6-40 billion CFUs PO qd (L. rhamnosus GG); Alt: 100 billion CFUs PO qd (L. rhamnosus CLR2 plus other probiotics); 8 billion CFUs PO qd (L. rhamnosus R0011 plus other probiotics); 5 billion CFUs PO bid (L. rhamnosus NIZO 3689 plus other probiotics)

diarrhea, antibiotic-assoc., peds pts

[Possibly Effective]

Dose: 10-20 billion CFUs PO qd (L. rhamnosus GG); Alt: 20 billion CFUs PO bid (L. rhamnosus GG); Info: used w/ conventional tx

diarrhea, chemo-related

[Insufficient Evidence]

Dose: 10-20 billion CFUs/day PO divided bid (L. rhamnosus GG)

diarrhea, rotaviral, peds pts

[Insufficient Evidence]

Dose: 10-100 billion CFUs/125 g fermented milk PO bid (L. rhamnosus GG); Alt: 10-100 billion CFUs freeze-dried powder PO bid (L. rhamnosus GG); 3 billion CFUs PO bid (L. rhamnosus GG)

gingivitis, adult pts

[Insufficient Evidence]

Dose: 4 billion CFUs lozenge PO qd (L. rhamnosus GG ATCC 53103 plus other probiotics)

gingivitis, peds pts

[Insufficient Evidence]

Dose: 1.84 billion CFUs lozenge PO bid (L. rhamnosus GG plus other probiotics); Info: for pts 13-15 yo

group B streptococcal colonization

[Insufficient Evidence]

Dose: 4 billion CFUs PO qd (L. rhamnosus GR-1 plus other probiotics); Info: start tx in pregnant pt at 35-37 wk gestation, then cont. until delivery

H. pylori infection

[Insufficient Evidence]

Dose: 100 million-10 billion CFUs PO bid x14 days (L. rhamnosus GG plus other probiotics); Info: used w/ standard tx

IBS

[Insufficient Evidence]

Dose: 10 billion CFUs/day PO divided bid (L. rhamnosus plus other probiotics); Alt: 2.5 billion CFUs PO bid (L. rhamnosus LR110 plus other probiotics)

lactose intolerance

[Insufficient Evidence]

Dose: 5 billion CFUs PO qd (L. rhamnosus HN001 plus other probiotics)

nonalcoholic fatty liver dz, peds pts

[Insufficient Evidence]

Dose: 13 billion CFUs PO qd (L. rhamnosus DSMZ 21690 plus other probiotics)

obesity, adult pts

[Insufficient Evidence]

Dose: 162 million CFUs PO bid (L. rhamnosus)

obesity, peds pts

[Insufficient Evidence]

Dose: 20 billion CFUs PO qd (L. rhamnosus HN001 plus other probiotics); Info: for childhood prevention; start tx in pregnant pt from early gestation, then cont. until 6mo postpartum

polycystic ovary syndrome

[Insufficient Evidence]

Dose: 10 billion CFUs PO bid (L. rhamnosus UBLR-58 plus other probiotics); Start: 10 billion CFUs PO qd x2mo (L. rhamnosus UBLR-58 plus other probiotics)

postop bowel function

[Insufficient Evidence]

Dose: 6 million CFUs PO q12h (L. rhamnosus GG); Start: day of surgery

postop recovery

[Insufficient Evidence]

Dose: 6 million CFUs PO q12h (L. rhamnosus GG); Start: day of surgery

postpartum depression

[Insufficient Evidence]

Dose: 6 billion CFUs PO qd (L. rhamnosus HN001); Start: 14-16 wk gestation

respiratory infections, adult pts

[Insufficient Evidence]

Dose: 2 billion CFUs PO qd (L. rhamnosus GG plus other probiotics)

respiratory infections, peds pts

[Insufficient Evidence]

Dose: 130-260 million CFUs PO qd (L. rhamnosus GG); Info: for pts 1-6 yo

traveler's diarrhea prophylaxis

[Insufficient Evidence]

Dose: 2 billion CFUs PO qd (L. rhamnosus GG); Info: start tx 2 days before trip, cont. until end of trip

UTI prevention, adult pts

[Insufficient Evidence (PO route)]

Dose: 1 billion CFUs PO bid (L. rhamnosus GR-1 plus other probiotics)

[Insufficient Evidence (PV route)]

Dose: 1.6 billion CFUs/0.5 g supp PV 2x/wk x2wk, then qmo (L. rhamnosus plus other probiotics); Alt: 100 billion CFUs/mL PV 2x/wk (L. rhamnosus)

UTI prevention, peds pts

[Insufficient Evidence]

Dose: 25 mg/kg/dose PO bid (L. rhamnosus plus other probiotics); Max: 1000 mg/day; Info: for pts 4 mo-5 yo