Mazza P, Zani F, Martelli P. Studies on the antibiotic resistance of Bacillus subtilis strains used in oral bacteriotherapy. Boll Chim Farm. 1992;131:401–8 http://www.ncbi.nlm.nih.gov/pubmed/1299263.

Martinez JL, Baquero F. Mutation frequencies and antibiotic resistance. Antimicrob Agents Chemother. 2000;44:1771–7 http://www.ncbi.nlm.nih.gov/pubmed/10858329. Accessed 29 Apr 2018. Enterogermina can be bought from pharmacies and drug stores close to you and also from online drug stores. But a doctor’s prescription is a must. Chemical composition

Ogata H, Goto S, Sato K, Fujibuchi W, Bono H, Kanehisa M. KEGG: Kyoto encyclopedia of genes and genomes. Nucleic Acids Res. 1999;27:29–34 http://www.ncbi.nlm.nih.gov/pubmed/9847135. Accessed 30 Jul 2017. Ghelardi E, Celandroni F, Salvetti S, Gueye SA, Lupetti A, Senesi S. Survival and persistence of Bacillus clausii in the human gastrointestinal tract following oral administration as spore-based probiotic formulation. J Appl Microbiol. 2015;119:552–9. https://doi.org/10.1111/jam.12848.

In the lumen of the distal colon, PPI treatment in the PPI control arm led to significant decreases in the levels of Coriobacteriaceae ( p = 0.037) and Selenomonadaceae ( p = 0.026) compared with the C stage of this arm ( Table 9 and Table S5). These changes were rescued by probiotic treatment, as seen by the relatively similar levels of Coriobacteriaceae and Selenomonadaceae in the TR and C stages of the preventive and curative arms ( Table 9 and Table S5). Větrovský T, Baldrian P. The variability of the 16S rRNA gene in bacterial genomes and its consequences for bacterial community analyses. PLoS One. 2013;8:e57923. https://doi.org/10.1371/journal.pone.0057923. A number of precautions should be considered before and while using Enterogermina. The precautions include: Nachin L, Nannmark U, Nystrom T. Differential roles of the universal stress proteins of Escherichia coli in oxidative stress resistance, adhesion, and motility. J Bacteriol. 2005;187:6265–72. https://doi.org/10.1128/JB.187.18.6265-6272.2005.Enterogermina ® (Sanofi) is a probiotic comprising four strains of Bacillus clausii (O/C, N/R, SIN, and T) that has been used effectively and safely for several decades [ 11]. Enterogermina was used as an adjunct to triple therapy (i.e., alongside two antibiotics and a PPI) in the treatment of Helicobacter pylori infections [ 11] and has been shown to reduce the adverse effects, such as diarrhea, nausea, and pain, which were largely attributed to the antibiotic component of the therapy [ 12]. Even though B. clausii has been in use for decades, several of its mechanisms of action have only been described in recent years, in the context of rotaviral infections and as a probiotic with antimicrobial and immunomodulatory activity [ 13, 14, 15]. Enterogermina does not cure the medical condition it is prescribed for but provides relieve that is short lived. In some cases, it is prescribed together with an antibiotic. Pregnancy, planning to conceive and lactating mothers. Enterogermina has not been shown to harm the growing baby or nursing baby. But it should be used with caution with the advice of your doctor.