Indian drug market is flooded with probiotics and synbiotics (combination of prebiotics and pro-biotics). The pharmaceutical companies are aggressively marketing them claiming its efficacy in various clinical conditions especially in treatment of diarrhea. It is important to remember that only few probiotics with specific strains such as Lactobacillus rhamnosus GG, L.reuteri and Sachromyces boulerdii have sufficient grade A evidence in reducing the duration of viral diarrhea and prevention of antibiotic associated diarrhea considerably(1). Ironically, none of bacterial probiotics available in Indian market mention about strain specificity, thus limiting their usefulness.

IAP National Task Force 2006 revised guidelines also do not recommend use of probiotics in management of acute diarrhea till further evaluation regarding its efficacy is established in our settings(2). Moreover, use of probiotics in preterm, low birth weight baby and immunocompromised children is fraught with risk of bacteraemia, endocarditis, and fungemia (3). The prescriber must consider their efficacy and safety based on evidence based medicine before recommending them to children.