Saccharomyces cerevisiae var. boulardii w codziennej praktyce lekarskiej: aktualne wskazania i dowody naukowe Artykuł przeglądowy
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Opublikowane:
maj 31, 2026
Słowa kluczowe:
Saccharomyces boulardii, biegunka poantybiotykowa, biegunka podróżnych, ostra biegunka, eradykacja H. pylori
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Abstrakt
Saccharomyces boulardii (S. boulardii) jest niepatogennym szczepem drożdży, wyizolowanym w 1923 r. w Indochinach przez Henriego Boularda podczas badań nad przeciwbiegunkowym działaniem skórek owoców liczi, spożywanych przez miejscową ludność. S. boulardii jest jedynym szczepem drożdży, z którym wykonano badania kliniczne metodą podwójnie ślepej próby, kontrolowane placebo. W praktyce klinicznej występuje w postaci żywych, liofilizowanych komórek, podawanych w postaci proszku lub kapsułek żelatynowych. S. boulardii stosowany doustnie jedynie przejściowo kolonizuje przewód pokarmowy człowieka. Stan równowagi mierzony stężeniem w jelicie grubym osiąga się po 2–3 dniach podawania, a po 6–7 dniach od przerwania podaży dochodzi do jego pełnej eliminacji ze stolca. W odróżnieniu od probiotyków bakteryjnych S. boulardii ma naturalną oporność na działanie antybiotyków (z wyjątkiem preparatów przeciwgrzybiczych). S. boulardii ma działanie przeciwsekrecyjne (czyli przeciwbiegunkowe) w zakażeniach wywołanych przez V. cholerae czy C. difficile. Wiele prac klinicznych i metaanaliz cytowanych w publikacji wykazało skuteczność w leczeniu lub profilaktyce takich schorzeń jak ostra biegunka, biegunka poantybiotykowa, biegunka podróżnych, biegunka związana z C. difficile czy terapia H. pylori. Aby uzyskać najlepsze efekty, S. boulardii powinien być włączany natychmiast i w dostatecznej dawce zalecanej w określonym zastosowaniu zarówno przez producenta, jak i badania kliniczne.
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Jak cytować
Albrecht, P. (2026). Saccharomyces cerevisiae var. boulardii w codziennej praktyce lekarskiej: aktualne wskazania i dowody naukowe . Medycyna Faktów , 19(1(70), 21-27. https://doi.org/10.24292/01.MF.0126.3
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Bibliografia
1. McFarland LV, Bernasconi P. S. boulardii: a review of an innovative biotherapeutic agent. Microb Ecol Health Dis. 1993; 6: 157-71.
2. Bruneel M, Patte F. Proprietes vitaminiques B (in vitro et in vivo) d’une levure du genre Saccharomyces (S. boulardii 17) prescrite lors de la prophylaxie et du traitement des accidents dus aux antibiotiques. La Clinique. 1972; 67: 19-204.
3. McCullough MJ, Clemons KV, McCusker JH et al. Stevens D.A. Species identyfication and virulence attributes of Saccharomyces boulardii (nom. inval.) J Clin Microb. 1998; 36(9): 2613-7.
4. Elmer G, Moyer K, Vega R et al. Pharmacokinetic studies of S. boulardii in patients with HIV-related chronic diarrhoea in healthy volunteers. XIX Int Congress on Microb Ecol and Disease Rome, 1994 (abstract book).
5. Neut C, Mahieux S, Dubreuil LJ. Antibiotic susceptibility of probiotic strains: is it reasonable to combine probiotics with antibiotics? Med Male Infect. 2017; 7: 477-83.
6. Moré MI, Swidsinski A. Saccharomyces boulardii CNCM I-745 supports regeneration of the intestinal microbiota after diarrheic dysbiosis – a review. Clin Exp Gastroenterol. 2015; 8: 237-55.
7. Boddy AV, Elmer GW, McFarland LV et al. Influence of antibiotics on the recovery of S. boulardii in rats. Pharmaceutic Res. 1991; 8: 796-800.
8. Blehaut H, Massot J, Elmer GW et al. Disposition kinetics of Saccharomyces boulardii in man and rat. Biopharm Drugs Dispos. 1989; 10: 353-64.
9. Toothaker RD, Elmer GW. Prevention of clindamycin-induced mortality in hamsters by Saccharomyces boulardii. Antimicrob Agents Chemother. 1984; 26 (4): 552-6.
10. Corthier G, Dubos F, Ducluzeau R. Prevention of Clostridium difficile induced mortality in gnotobiotic mice by Saccharomyces boulardii. Can J Microbiol. 1986; 32(11): 894-6.
11. Castex F, Corthier G, Jouvert S et al. Prevention of Clostridium difficile induced experimental pseudomembranous colitis by Saccharomyces boulardii: a scanning electron microscopic and microbiological study. J Gen Microbiol. 1990; 136 (6): 1085-9.
12. Pothoulakis C, Kelly CP, Joshi MA et al. Saccharomyces boulardii inhibits Clostridium difficile toxin A binding and enterotoxicity in rat ileum. Gastroenterology. 1993; 104(4): 1108-15.
13. Brandao R, Castro IM, Bambirra EA et al. Intracellular signal triggered by cholera toxin in S. boulardii and Saccharomyces cerevisiae. Appl Environ Microbiol. 1998; 64: 564-8.
14. Gopalan S, Ganapathy S, Mitra M et al. Unique Properties of Yeast Probiotic Saccharomyces boulardii CNCM I-745: A Narrative Review. Cureus. 2023; 15(10): e46314.
15. Kaźmierczak-Siedlecka K, Ruszkowski J, Fic M et al. Saccharomyces boulardii CNCM I-745: A Non-bacterial Microorganism Used as Probiotic Agent in Supporting Treatment of Selected Diseases. Curr Microbiol. 2020; 77(9): 1987-96.
16. Guarino A, Lo Vecchio A, Dias JA et al. Universal Recommendations for the Management of Acute Diarrhea in Nonmalnourished Children. J Pediatr Gastroenterol Nutr. 2018; 67(5): 586-93.
17. Padayachee M, Visser J, Viljoen E et al. Efficacy and safety of Saccharomyces boulardii in the treatment of acute gastroenteritis in the pediatric population: a systematic review. S Afr J Clin Nutr. 2019; 32: 358-69.
18. Szajewska H, Kołodziej M, Zalewski BM. Systematic review with meta-analysis: Saccharomyces boulardii for treating acute gastroenteritis in children – a 2020 update. Aliment Pharmacol Ther. 2020; 51: 678-88.
19. Fu H, Li J, Xu X et al. Effectiveness and safety of Saccharomyces boulardii for the treatment of acute gastroenteritis in the pediatric population: a systematic review and meta-analysis of randomized controlled trials. Comput Math Methods Med. 2022; 2022: 6234858.
20. Szajewska H, Canani RB, Guarino A et al.; ESPGHAN Working Group for Probiotics Prebiotics. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children. J Pediatr Gastroenterol Nutr. 2016; 62(3): 495-506.
21. Kotowska M, Albrecht P, Szajewska H. Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: a randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther. 2005; 21(5): 583-90.
22. McFarland LV. Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. World J Gastroenterol. 2010; 16: 2202-22.
23. McFarland LV, Goh S. Preventing pediatric antibiotic-associated diarrhoea and Clostridium difficile infections with probiotics: a meta-analysis. World J Meta-Anal. 2013; 1: 102-20.
24. Szajewska H, Kołodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2015; 42: 793-801.
25. Yang Q, Hu Z, Lei Y et al. Overview of systematic reviews of probiotics in the prevention and treatment of antibiotic-associated diarrhea in children. Front Pharmacol. 2023; 14: 1153070.
26. Surawicz CM, McFarland LV, Elmer G et al. Treatment of recurrent Clostridium difficile colitis with vancomycin and Saccharomyces boulardii. Am J Gastroenterol. 1989; 84: 1285-7.
27. McFarland L, Surawicz CM, Greenberg RN et al. A randomized placebo controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA. 1994; 271: 1913-8.
28. McFarland LV, Surawicz CM, Greenberg RN et al. Prevention of betalaktam associated diarrhoea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol. 1995; 90: 439-48.
29. Tariq R, Waqas TM, Maham H et al. Systematic Review and Meta-Analysis: Safety and Efficacy of Saccharomyces boulardii for Prevention of Clostridioides difficile Infection. Journal Gastrointest Infections. 2023; 12: 94-100.
30. Esmaeilinezhad Z, Ghosh NR, Walsh CM et al. Probiotics for the prevention of Clostridioides difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev. 2025; 9(9): CD006095.
31. Li M, Xie Y. Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication of Helicobacter pylori: a meta-analysis. Front Cell Infect Microbiol. 2025; 15: 1441185.
32. Kollaritsch H, Holst H, Grobara P et al. Prevention of traveler’s diarrhea with Saccharomyces boulardii. Results of a placebo controlled double-blind study. Fortschr Med. 1993; 111(9): 152-6.
33. McFarland LV. Meta-analysis of probiotics for the prevention of traveler’s diarrhea. Travel Med Infect Dis. 2007; 5(2): 97-105.
34. Alharbi BF, Alateek AA. Investigating the influence of probiotics in preventing Traveler’s diarrhea: Meta-analysis based systematic review. Travel Med Infect Dis. 2024; 59: 102703.
35. Abid R, Waseem H, Ali J et al. Probiotic yeast saccharomyces: back to nature to improve human health. J Fungi (Basel). 2022; 8: 444.
36. Feizizadeh S, Salehi-Abargouei A, Akbari V. Efficacy and safety of Saccharomyces boulardii for acute diarrhea. Pediatrics. 2014; 134: e176-91.
37. Moré MI, Swidsinski A. Saccharomyces boulardii CNCM I-745 supports regeneration of the intestinal microbiota after diarrheic dysbiosis – a review. Clin Exp Gastroenterol. 2015; 8: 237-55.
38. Karpa KD. Probiotics for Clostridium difficile diarrhea: putting it into perspective. Ann Pharmacother. 2007; 41: 1284-7.
39. Hennequin C, Kauffmann-Lacroix C, Jobert A et al. Possible role of catheters in Saccharomyces boulardii fungemia. Eur J Clin Microbiol Infect Dis. 2000; 19: 16-20.
2. Bruneel M, Patte F. Proprietes vitaminiques B (in vitro et in vivo) d’une levure du genre Saccharomyces (S. boulardii 17) prescrite lors de la prophylaxie et du traitement des accidents dus aux antibiotiques. La Clinique. 1972; 67: 19-204.
3. McCullough MJ, Clemons KV, McCusker JH et al. Stevens D.A. Species identyfication and virulence attributes of Saccharomyces boulardii (nom. inval.) J Clin Microb. 1998; 36(9): 2613-7.
4. Elmer G, Moyer K, Vega R et al. Pharmacokinetic studies of S. boulardii in patients with HIV-related chronic diarrhoea in healthy volunteers. XIX Int Congress on Microb Ecol and Disease Rome, 1994 (abstract book).
5. Neut C, Mahieux S, Dubreuil LJ. Antibiotic susceptibility of probiotic strains: is it reasonable to combine probiotics with antibiotics? Med Male Infect. 2017; 7: 477-83.
6. Moré MI, Swidsinski A. Saccharomyces boulardii CNCM I-745 supports regeneration of the intestinal microbiota after diarrheic dysbiosis – a review. Clin Exp Gastroenterol. 2015; 8: 237-55.
7. Boddy AV, Elmer GW, McFarland LV et al. Influence of antibiotics on the recovery of S. boulardii in rats. Pharmaceutic Res. 1991; 8: 796-800.
8. Blehaut H, Massot J, Elmer GW et al. Disposition kinetics of Saccharomyces boulardii in man and rat. Biopharm Drugs Dispos. 1989; 10: 353-64.
9. Toothaker RD, Elmer GW. Prevention of clindamycin-induced mortality in hamsters by Saccharomyces boulardii. Antimicrob Agents Chemother. 1984; 26 (4): 552-6.
10. Corthier G, Dubos F, Ducluzeau R. Prevention of Clostridium difficile induced mortality in gnotobiotic mice by Saccharomyces boulardii. Can J Microbiol. 1986; 32(11): 894-6.
11. Castex F, Corthier G, Jouvert S et al. Prevention of Clostridium difficile induced experimental pseudomembranous colitis by Saccharomyces boulardii: a scanning electron microscopic and microbiological study. J Gen Microbiol. 1990; 136 (6): 1085-9.
12. Pothoulakis C, Kelly CP, Joshi MA et al. Saccharomyces boulardii inhibits Clostridium difficile toxin A binding and enterotoxicity in rat ileum. Gastroenterology. 1993; 104(4): 1108-15.
13. Brandao R, Castro IM, Bambirra EA et al. Intracellular signal triggered by cholera toxin in S. boulardii and Saccharomyces cerevisiae. Appl Environ Microbiol. 1998; 64: 564-8.
14. Gopalan S, Ganapathy S, Mitra M et al. Unique Properties of Yeast Probiotic Saccharomyces boulardii CNCM I-745: A Narrative Review. Cureus. 2023; 15(10): e46314.
15. Kaźmierczak-Siedlecka K, Ruszkowski J, Fic M et al. Saccharomyces boulardii CNCM I-745: A Non-bacterial Microorganism Used as Probiotic Agent in Supporting Treatment of Selected Diseases. Curr Microbiol. 2020; 77(9): 1987-96.
16. Guarino A, Lo Vecchio A, Dias JA et al. Universal Recommendations for the Management of Acute Diarrhea in Nonmalnourished Children. J Pediatr Gastroenterol Nutr. 2018; 67(5): 586-93.
17. Padayachee M, Visser J, Viljoen E et al. Efficacy and safety of Saccharomyces boulardii in the treatment of acute gastroenteritis in the pediatric population: a systematic review. S Afr J Clin Nutr. 2019; 32: 358-69.
18. Szajewska H, Kołodziej M, Zalewski BM. Systematic review with meta-analysis: Saccharomyces boulardii for treating acute gastroenteritis in children – a 2020 update. Aliment Pharmacol Ther. 2020; 51: 678-88.
19. Fu H, Li J, Xu X et al. Effectiveness and safety of Saccharomyces boulardii for the treatment of acute gastroenteritis in the pediatric population: a systematic review and meta-analysis of randomized controlled trials. Comput Math Methods Med. 2022; 2022: 6234858.
20. Szajewska H, Canani RB, Guarino A et al.; ESPGHAN Working Group for Probiotics Prebiotics. Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children. J Pediatr Gastroenterol Nutr. 2016; 62(3): 495-506.
21. Kotowska M, Albrecht P, Szajewska H. Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea in children: a randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther. 2005; 21(5): 583-90.
22. McFarland LV. Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. World J Gastroenterol. 2010; 16: 2202-22.
23. McFarland LV, Goh S. Preventing pediatric antibiotic-associated diarrhoea and Clostridium difficile infections with probiotics: a meta-analysis. World J Meta-Anal. 2013; 1: 102-20.
24. Szajewska H, Kołodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2015; 42: 793-801.
25. Yang Q, Hu Z, Lei Y et al. Overview of systematic reviews of probiotics in the prevention and treatment of antibiotic-associated diarrhea in children. Front Pharmacol. 2023; 14: 1153070.
26. Surawicz CM, McFarland LV, Elmer G et al. Treatment of recurrent Clostridium difficile colitis with vancomycin and Saccharomyces boulardii. Am J Gastroenterol. 1989; 84: 1285-7.
27. McFarland L, Surawicz CM, Greenberg RN et al. A randomized placebo controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA. 1994; 271: 1913-8.
28. McFarland LV, Surawicz CM, Greenberg RN et al. Prevention of betalaktam associated diarrhoea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol. 1995; 90: 439-48.
29. Tariq R, Waqas TM, Maham H et al. Systematic Review and Meta-Analysis: Safety and Efficacy of Saccharomyces boulardii for Prevention of Clostridioides difficile Infection. Journal Gastrointest Infections. 2023; 12: 94-100.
30. Esmaeilinezhad Z, Ghosh NR, Walsh CM et al. Probiotics for the prevention of Clostridioides difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev. 2025; 9(9): CD006095.
31. Li M, Xie Y. Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication of Helicobacter pylori: a meta-analysis. Front Cell Infect Microbiol. 2025; 15: 1441185.
32. Kollaritsch H, Holst H, Grobara P et al. Prevention of traveler’s diarrhea with Saccharomyces boulardii. Results of a placebo controlled double-blind study. Fortschr Med. 1993; 111(9): 152-6.
33. McFarland LV. Meta-analysis of probiotics for the prevention of traveler’s diarrhea. Travel Med Infect Dis. 2007; 5(2): 97-105.
34. Alharbi BF, Alateek AA. Investigating the influence of probiotics in preventing Traveler’s diarrhea: Meta-analysis based systematic review. Travel Med Infect Dis. 2024; 59: 102703.
35. Abid R, Waseem H, Ali J et al. Probiotic yeast saccharomyces: back to nature to improve human health. J Fungi (Basel). 2022; 8: 444.
36. Feizizadeh S, Salehi-Abargouei A, Akbari V. Efficacy and safety of Saccharomyces boulardii for acute diarrhea. Pediatrics. 2014; 134: e176-91.
37. Moré MI, Swidsinski A. Saccharomyces boulardii CNCM I-745 supports regeneration of the intestinal microbiota after diarrheic dysbiosis – a review. Clin Exp Gastroenterol. 2015; 8: 237-55.
38. Karpa KD. Probiotics for Clostridium difficile diarrhea: putting it into perspective. Ann Pharmacother. 2007; 41: 1284-7.
39. Hennequin C, Kauffmann-Lacroix C, Jobert A et al. Possible role of catheters in Saccharomyces boulardii fungemia. Eur J Clin Microbiol Infect Dis. 2000; 19: 16-20.