Evolution of the probiotic paradigm: From general recommendations to the targeted utilization of specific strains. A review

The contemporary pharmaceutical market is characterized by a plethora of probiotic formulations with various microorganism combinations, dosages, and claimed indications for usage. Different probiotics show divergent evidence for efficacy and safety, and markedly different spectra of action. This diversity presents a significant challenge for practitioners in selecting the optimal probiotic for individual patients, necessitating consideration of evidence-based medicine principles and unique clinical characteristics. Strain specificity is the most critical attribute of probiotics, as it directly influences their functional potential. Recent advancements have identified a select group of probiotic strains with demonstrated efficacy for several common clinical conditions, particularly in relation to functional gastrointestinal disorders. This development facilitates a paradigm shift for pediatricians, moving from the empirical use of general probiotics to the targeted selection of specific strains or combinations designed to address well-defined clinical issues. Both Russian and international studies underscore the substantial impact of intestinal microbiota composition on the health of young children. In routine clinical practice, pediatricians frequently observe the consequences of imbalances in the qualitative and quantitative composition of the intestinal microbiota. In this context, combinations of Pediococcus pentosaceus CECT 8330/Bifidobacterium longum CECT 7894 (Bifistim® Baby) and Lactobacillus plantarum CECT 7315/ CECT 7316 (Bifistim® Immuno) strains are of particular interest. These strains and their respective combinations exhibit strain-specific effects that are beneficial for infants in their early months and years. This review analyzes the role of these strains in shaping microbiota, preventing and correcting functional gastrointestinal disorders, and supporting immune function.