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One 65-100 mL bottle of the fermented milk drink daily, delivering roughly 6.5 x 10^9 to 1 x 10^11 CFU depending on the product. Doses across trials span this whole range with no dose-comparison study to separate them.

Any time

Fermented milk drink containing L. casei Shirota (Yakult), 65-100 mL daily

Prevention and maintenance are DIFFERENT doses and are often conflated. Preventing the first onset of acute pouchitis used 900 billion CFU/day (1 sachet). Maintaining remission in established chronic or refractory pouchitis — where the effect size is largest — used 6 g/day, which at 5 x 10^11 viable bacteria per gram is about 3 trillion CFU/day, in both maintenance trials. As a ulcerative colitis add-on, 3.6 trillion CFU daily; the active-UC induction trial went highest at 3.6 trillion CFU TWICE daily (7.2 trillion/day), and the paediatric trial lowest at 450 billion/day weight-based

Any time

Refrigerated sachet of the De Simone Formulation

• Immunocompromise or immunosuppression (class-level precaution for live probiotics)
• Critical illness or indwelling central venous catheter

• Proton pump inhibitors

• Severe immunocompromise or immunosuppression (class-level precaution for live probiotics)
• Critical illness or indwelling central venous catheter

• Systemic antibiotics