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Moderate evidenceGut health

Bacillus Clausii

A spore probiotic used for decades in Europe and Latin America, mostly as Enterogermina. Meta-analyses in children with acute diarrhea show a modest shortening of illness; evidence in adults is thinner.

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What the science says

  • Acute diarrhea in children Moderate evidence

    A systematic review and meta-analysis of randomized controlled trials found that B. clausii shortened the duration of acute diarrhea in children by roughly a day, though the individual trials were of variable quality. A later comprehensive review and meta-analysis of the Enterogermina preparation reached similar conclusions.

  • Antibiotic-associated diarrhea Limited evidence

    A systematic review of the four-strain B. clausii preparation for preventing antibiotic-associated diarrhea and gastrointestinal side effects found supportive but mostly non-randomized or small studies, weaker than the evidence for S. boulardii or L. rhamnosus GG.

  • Antibiotic resistance as a feature Limited evidence

    The commercial strains are naturally resistant to several antibiotics, which is why the product is taken alongside antibiotic therapy; whether that translates into better clinical outcomes has not been firmly established.

Dosage & safety

Studied doseTypical trials used 2 billion spores per vial, two to three times daily, for 5–10 days in acute diarrhea.
SafetyWell tolerated, with a long record of use. Rare bacteremia has been reported in immunocompromised patients and those with central lines. Persistent, bloody or severe diarrhea, and dehydration in young children, need medical care rather than a probiotic alone.

How to take it

TimingSpread the vials across the day, typically for 5 to 10 days at a time.
With food?Either way, since the spores survive stomach acid.
Worth knowingShake the vial and drink it straight, or mix it into a cool drink rather than a hot one.

Interactions

With medications

  • antibiotics

    The commercial B. clausii strains carry resistance genes to several antibiotics including tetracycline, chloramphenicol, streptomycin and rifampicin, so they persist during antibiotic treatment unlike most probiotics. it can be taken alongside a course, but confirm the product uses these strains

  • immunosuppressants and chemotherapy

    Bacteremia has been reported in immunocompromised patients and those with central venous lines. do not use without medical advice

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does Bacillus clausii (Enterogermina) work for diarrhea in children?

Yes, modestly: meta-analyses of randomized trials found B. clausii shortened acute diarrhea in children by roughly a day, which is moderate evidence despite variable trial quality.

Can I take Bacillus clausii with antibiotics?

Yes. The commercial B. clausii strains are naturally resistant to several antibiotics, so they persist during a course; confirm the product uses these strains. Evidence that it prevents antibiotic-associated diarrhea is limited.

How much Bacillus clausii should I take?

Typical trials used 2 billion spores of B. clausii per vial, two to three times daily, for 5–10 days in acute diarrhea, mixed into a cool rather than hot drink.

Is Bacillus clausii safe?

B. clausii is well tolerated, though rare bacteremia has been reported in immunocompromised patients and those with central lines. Persistent, bloody or severe diarrhea, or dehydration in young children, needs medical care.

Scientific references

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