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Recent studies have strongly confirmed the health benefits of a variety of probiotic microorganisms. However, some issues regarding the use of probiotics currently remain unresolved or ambiguous. This article highlights some controversial issues of probiotic use in clinical practice such as regulatory status of probiotics, co-administration of probiotics and antibiotics, potential impact of probiotics on antimicrobial resistance emergence and spread, dosing and duration of probiotic use, contraindications and some other debatable topics.

Over the last 20 years, there is an ever-increasing interest in the use of probiotics for the variety of health problems worldwide. However, the evidence base for various probiotic microorganisms differs significantly. This review provides data on the efficacy of the two best-studied probiotic strains with established positive effects on human health, namely Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb-12. The efficacy of probiotics for the treatment of acute diarrhea, prevention of antibiotic-associated diarrhea and nosocomial infections, as adjuvant therapy in H. pylori-associated diseases was proven in numerous clinical studies. The evidence of positive effects of probiotics on the prevention of respiratory tract infections in children, in patients with atopic dermatitis and other medical conditions is also discussed. The practical guidelines of the international societies on the use of probiotics are reviewed. A particular attention is paid to dosing and safety issues in the use of L. rhamnosus GG and B. lactis Bb-12 in clinical practice, including vulnerable patient categories.