Usage
- Lactobacillus brevis (now Levilactobacillus brevis) is a probiotic, a type of “good” bacteria found naturally in the human body and in fermented foods. It is used to support gut health and is being investigated for a variety of potential health benefits. These include managing alcohol-related liver disease, bacterial vaginosis (overgrowth of bacteria in the vagina), common cold, dry skin, gum disease (gingivitis), and insomnia.
- Pharmacological Classification: Probiotic, biological agent
- Mechanism of Action: L. brevis exerts its effects primarily through the modulation of the gut microbiota. It competes with pathogenic bacteria for resources and adhesion sites, produces antimicrobial substances (like bacteriocins and organic acids), and enhances the host’s immune response. L. brevis is also known to increase aerobic stability in silage production.
Alternate Names
- L. brevis
- Lactobacillus brevis
How It Works
- Pharmacodynamics: L. brevis primarily affects the gut by altering the composition and function of the gut microbiota. It supports a healthy balance of microorganisms, promoting beneficial bacteria and inhibiting the growth of harmful ones.
- Pharmacokinetics: Oral administration of L. brevis leads to colonization of the gastrointestinal tract. It does not get absorbed into the bloodstream in significant amounts. Its elimination is primarily through fecal excretion.
- Mode of Action: L. brevis competes with pathogenic bacteria for nutrients and attachment sites in the gut, limiting their growth. It also produces lactic acid and other antimicrobial substances, like bacteriocins, creating an environment unfavorable for pathogens. L. brevis can stimulate the immune system.
- Receptor Binding, Enzyme Inhibition, Neurotransmitter Modulation: The exact mechanisms of receptor binding, enzyme inhibition, or neurotransmitter modulation are not fully understood.
- Elimination Pathways: Primarily fecal excretion.
Dosage
Standard Dosage
Adults:
Oral administration of 1 billion to 10 billion colony-forming units (CFUs) daily, typically for 1 to 4 months, or up to 12 billion CFUs daily for up to 3 months for certain applications. Vaginal application of 4 billion CFUs daily for up to 6 months has also been used.
Children:
Doses of up to 4 billion CFUs daily for up to 2 months or 10 billion CFUs for 4 weeks have been used in children aged 4-14 years.
Special Cases:
- Elderly Patients: No specific dosage adjustments are defined but start with lower doses and adjust as needed.
- Patients with Renal Impairment: No specific dosage adjustments are established.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are established.
- Patients with Comorbid Conditions: Dose adjustments may be needed on a case-by-case basis.
Clinical Use Cases
Dosing for specific clinical use cases (intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations) has not been specifically defined. Clinical studies are needed to determine optimal use in these settings.
Dosage Adjustments
Dose adjustments for specific clinical use cases are currently not standardized and may be needed on a case-by-case basis.
Side Effects
Common Side Effects
Generally well-tolerated. Some individuals might experience mild gastrointestinal discomfort, such as bloating or gas.
Rare but Serious Side Effects
Rare cases of systemic infections (e.g., bacteremia, endocarditis) have been reported, particularly in immunocompromised individuals.
Long-Term Effects
Long-term effects are not well-established.
Adverse Drug Reactions (ADR)
Systemic infections (rare).
Contraindications
- Individuals with a known hypersensitivity to L. brevis or any component of the probiotic formulation.
- Immunocompromised individuals should use with caution, as there’s a theoretical risk of systemic infection.
Drug Interactions
- Immunosuppressants could theoretically reduce the effectiveness of L. brevis.
- Antibiotics may alter the gut microbiota, including L. brevis, and their concurrent use should be carefully considered.
Pregnancy and Breastfeeding
Safety during pregnancy and breastfeeding is not definitively established, although generally considered safe when used appropriately. Consult a healthcare professional before use during pregnancy or lactation.
Drug Profile Summary
- Mechanism of Action: Modulates gut microbiota, competes with pathogens, produces antimicrobial substances.
- Side Effects: Generally well-tolerated, mild GI discomfort possible; rarely, systemic infection in immunocompromised.
- Contraindications: Hypersensitivity, severe immunocompromise.
- Drug Interactions: Immunosuppressants, antibiotics.
- Pregnancy & Breastfeeding: Consult a healthcare professional.
- Dosage: Adults: 1-10 billion CFUs daily orally. Children: Up to 4 billion CFUs daily.
- Monitoring Parameters: Monitor for GI tolerance and signs of infection in vulnerable populations.
Popular Combinations
Often combined with other probiotic strains for synergistic effects on gut health. Specific combinations and their rationale vary depending on the intended use.
Precautions
- Assess patient’s immune status.
- Specific Populations:
- Pregnant Women: Consult healthcare professional.
- Breastfeeding Mothers: Consult healthcare professional.
- Children & Elderly: Generally safe.
- Lifestyle Considerations: No specific restrictions on lifestyle factors like alcohol, smoking, or diet.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Lactobacillus Brevis?
A: Adults: 1-10 billion CFUs/day orally. Children: Consult a healthcare professional.
Q2: Is Lactobacillus brevis safe during pregnancy?
A: Safety isn’t fully established. Consult a healthcare professional.
Q3: What are the common side effects of L. brevis?
A: Generally well-tolerated, mild GI discomfort possible.
Q4: Can L. brevis be used in immunocompromised patients?
A: Use with caution, monitor closely.
Q5: How does L. brevis work?
A: Modulates gut microbiota, competes with pathogens, produces antimicrobial substances.
Q6: Are there any drug interactions with L. brevis?
A: Potential interactions with immunosuppressants and antibiotics.
Q7: What are the alternative names for L. brevis?
A: Levilactobacillus brevis, L. brevis.
Q8: Can L. brevis be used with other probiotics?
A: Yes, often combined with other strains for synergistic effects.
Q9: What should patients be monitored for when taking L. brevis?
A: Monitor for GI tolerance and signs of infection (especially immunocompromised patients).
