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ALIMENTARY TRACT AND METABOLISM › ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE AGENTS › ANTIDIARRHEAL MICROORGANISMS › Antidiarrheal microorganisms
escherichia coli
A07FA03
Forms & Strengths
- Oral capsule (e.g., Mutaflor): 10^9 to 10^10 viable cells of Escherichia coli strain Nissle 1917
Adult Dosing
- Initial: 1 capsule (10^9 viable cells) daily for 2 to 4 days, then increase to 2 capsules daily.
- Maintenance in ulcerative colitis: 1 to 2 capsules daily as directed by clinical response.
Pediatric Dosing
- Safety and efficacy not well established in young children; use in adolescents guided by clinical protocols, typically starting with 1 capsule daily.
Indications
- Maintenance of remission in ulcerative colitis
- Management of chronic constipation
- Prevention and treatment of functional gastrointestinal disorders
Mechanism of Action
- Non-pathogenic probiotic E. coli strain that colonizes the human gastrointestinal tract.
- Exerts competitive exclusion against pathogenic bacteria, produces antimicrobial peptides (microcins), and modulates mucosal immune responses to reduce intestinal inflammation.
Contraindications
- Hypersensitivity to E. coli Nissle 1917 or excipients
- Severe immunosuppression or immunocompromised states due to risk of bacteremia
- Presence of central venous catheters
Adverse Reactions
- Mild and transient flatulence
- Abdominal cramps
- Bloating during initial days of administration
- Rare risk of systemic infection (bacteremia) in severely immunocompromised patients
Drug Interactions
- Antibacterial agents (antibiotics) may reduce the efficacy of the probiotic; separate administration times if possible.
- Sulfonamides may inhibit the growth of the bacterial strain.
Curated Content: Needs Vetting Before Put to Clinical Use