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Moderate evidenceGut health

Enterococcus Faecium

A probiotic Enterococcus licensed as a medicine for diarrhoea in parts of Europe. The trial data for acute and antibiotic-associated diarrhoea are reasonable, but the species itself raises legitimate safety questions.

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What the science says

  • Acute and antibiotic-associated diarrhoea Moderate evidence

    An analysis of four previously unpublished studies of E. faecium SF68, including RCTs with 1,143 and 1,397 patients, found a shorter time to resolution of acute diarrhoea (median 3 versus 4 days) and fewer cases of antibiotic-associated diarrhoea (8.6% versus 16.2%).

  • Combination products for antibiotic-associated diarrhoea Moderate evidence

    A meta-analysis of RCTs of live combined Bacillus subtilis and Enterococcus faecium found benefit for both treatment and prevention of antibiotic-associated diarrhoea, though the included trials are largely Chinese and of variable quality.

  • Tolerating H. pylori eradication therapy Limited evidence

    A randomized, double-blind, placebo-controlled trial found E. faecium 129 BIO 3B-R reduced side effects of Helicobacter pylori eradication therapy in adults. This is a single trial.

Dosage & safety

Studied doseSF68 studies used capsules of roughly 7.5×10^7 CFU, two to three times daily for about 7 days.
SafetyThe caveat that matters: enterococci are opportunistic pathogens and can carry transferable antibiotic-resistance genes, which is why European safety assessment requires strain-level qualification. Use only characterised commercial strains, and avoid in immunosuppression, in people at risk of endocarditis such as those with prosthetic valves, and in critical illness.

How to take it

TimingShort courses of about a week, two to three times daily, as the SF68 studies used.
With food?With a meal, which improves survival through the stomach.
Worth knowingOnly use a named, characterised strain such as SF68 — generic 'E. faecium' with no strain designation is exactly the product European regulators flagged over resistance genes.

Interactions

With medications

  • antibiotics

    The antibiotic kills the culture. separate by at least 2 hours

  • immunosuppressants

    Enterococci are opportunistic pathogens and have caused bacteraemia in immunosuppressed patients. do not use without medical supervision

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

Frequently asked questions

Does Enterococcus faecium help diarrhea?

Enterococcus faecium SF68 has moderate evidence: large trials found a shorter time to resolution of acute diarrhoea (median 3 versus 4 days) and fewer cases of antibiotic-associated diarrhoea (8.6% versus 16.2%). Combination products with Bacillus subtilis also showed benefit, in largely Chinese trials of variable quality.

Is Enterococcus faecium a safe probiotic?

Enterococcus faecium raises legitimate safety questions: enterococci are opportunistic pathogens and can carry transferable antibiotic-resistance genes. Use only a named, characterised strain such as SF68, and avoid it in immunosuppression, with prosthetic valves or other endocarditis risk, and in critical illness.

How do I take Enterococcus faecium?

SF68 studies of Enterococcus faecium used capsules two to three times daily with meals for about 7 days, as a short course. Separate it from antibiotics by at least 2 hours.

Does Enterococcus faecium reduce H. pylori treatment side effects?

One randomized, placebo-controlled trial found Enterococcus faecium 129 BIO 3B-R reduced side effects of Helicobacter pylori eradication therapy in adults. As a single trial, this is limited evidence.

Scientific references

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