BMJ  2007;335:414 (1 September), doi:10.1136/bmj.39317.508079.80

Letters

Probiotics in children

All nutritional supplements should be classified as drugs

The study by Canani et al concluded that probiotics should be classified as drugs, and doctors should select preparations for which evidence of efficacy, in a given clinical condition, is supported by solid data.¹

All nutritional supplements that are sold on the basis of their health promoting properties should be classified as drugs, and they should have to undergo the same rigorous process as pharmaceutical drugs to establish their efficacy and safety before they are placed on the market. The global market for probiotics and supplements continues to grow, and a growing number of "nutritionists" and nutritional supplements are trying to cash in. Consumers deserve to have accurate information about the efficacy and potential side effects of these products in the same way that they do for other over the counter drugs. If these substances were classified as drugs, doctors could then prescribe them on the NHS for their specific indication supported by good evidence. There are a few randomised controlled trials of the effectiveness of specific probiotics for certain diagnoses, and for most so called probiotics there is only weak or no evidence of their effectiveness. Classifying such substances as drugs would also make the label "probiotic" meaningful as a substance with proved health benefit and prevent ineffective preparations cashing in by association.

Greater Manchester Health Protection Unit, Manchester M30 0NJ

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Competing interests: None declared.

References

1. Canani RB, Cirillo P, TerrinG, Cesarano L, Spagnuolo MI, de Vincenzo A, et al. Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations. BMJ 2007;335:340-2. (18 August.)[Abstract/Free Full Text]

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Relevant Article

Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations

Roberto Berni Canani, Pia Cirillo, Gianluca Terrin, Luisa Cesarano, Maria Immacolata Spagnuolo, Anna De Vincenzo, Fabio Albano, Annalisa Passariello, Giulio De Marco, Francesco Manguso, and Alfredo Guarino
BMJ 2007 335: 340. [Abstract] [Full Text] [PDF]