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Yes, S. boulardii is effective and indicated in the prevention of antibiotic-associated diarrhea* and therefore, should be administered concomitantly with the antibiotics. As S. boulardii is a yeast, it is resistant to antibiotics and the mixture will not alter its properties and efficacy. The meta-analysis of Szajewska[1] confirms the importance of combining S. boulardii and antibiotics in an at-risk population for the prevention of AAD.
*This efficacy has been demonstrated in a number of clinical trials in children as well as adults.

1. Szajewska H, ALIMENT PHARMACOL THER. 2005 Sep 1;22(5):365-72
2. Czerucka D, Piche T, Rampal P.ALIMENT PHARMACOL THER. 2007 Sep 15;26(6):767-78

S. boulardii can be administered to gluten intolerant patients. Neither the content (S. boulardii and excipient) nor the capsule contains gluten. The culture medium used to grow S. boulardii may contain a very small quantity of barley, which can contain gluten. A study was performed by Biocodex to determine the quantity of gliadin (responsible for relapse celiac disease) that may be present in S. boulardii. Using the ELISA technique on ten batches of 50 mg S. boulardii detected no gliadin (detection limit=20μg/kg).

S. boulardii capsules and sachets contain 32.5 mg of lactose/250 mg dose.

1. M. Montalto et Al, ALIMENT PHARMACOL THER. 2008 Oct 15;28(8):1003-12

S. boulardii is a yeast, so it can be combined with any other products except antifungal agents (as it may reduce efficacy). Nevertheless, check the other treatment package insert for their drug interactions.

S. boulardii has no drug-drug interaction but mineral clays do have as they reduce the diarrhea by absorbing the water. Therefore the simultaneous co-administration of S. boulardii and mineral clay may interact and reduce efficacy. Please check the mineral clay package insert.