Saccharomyces Boulardii in Ireland: Benefits, Antibiotics, Dosage and Safety

Saccharomyces boulardii is the odd one out on the probiotic shelf: a yeast, not a bacterium, which is why antibacterial antibiotics do not target it the way they can many bacterial probiotic strains. It is one of the best-studied individual microorganisms for antibiotic-associated diarrhoea, and it also carries a safety warning that most pages skip. This guide sets out what S. boulardii is, what it has been shown to do condition by condition, where the SIBO and candida claims come from, how to take it, and who should not take it at all.

Saccharomyces boulardii (S. boulardii, Saccharomyces cerevisiae var. boulardii) definition: Saccharomyces boulardii is a non-pathogenic probiotic yeast, genetically a strain of Saccharomyces cerevisiae, supplied in food supplements as freeze-dried live cells in capsules or sachets, which survives antibacterial antibiotics, passes through the gut without colonising it permanently, and has been studied mainly for preventing antibiotic-associated diarrhoea.

What is Saccharomyces boulardii? A yeast, not a bacterium

Every other probiotic you are likely to meet in an Irish pharmacy is a bacterium: Lactobacillus, Bifidobacterium, Streptococcus. Saccharomyces boulardii is a yeast. Genetically it sits inside Saccharomyces cerevisiae, the species that makes bread rise and beer ferment, which is why you will sometimes see it written S. cerevisiae var. boulardii. It differs from baker's yeast in ways that matter for a probiotic: it grows best at 37 °C, tolerates stomach acid and bile, and is less able to sporulate.^[14]

The story usually told, and recounted in the Kelesidis and Pothoulakis review, is that French microbiologist Henri Boulard isolated it in the 1920s in Indochina after noticing that locals chewing lychee and mangosteen skins seemed to fare better during a cholera outbreak.^[14] The strain he isolated was later catalogued as CNCM I-745 and has been sold as a pharmacy product in France and much of Europe for decades. That single strain is behind most of the trials below.

Being a yeast gives S. boulardii its defining practical property: antibacterial antibiotics do not touch it. Many bacterial probiotic strains are susceptible to commonly prescribed antibiotics, which is why bacterial products are usually separated from the antibiotic dose; susceptibility varies by strain and by antibiotic. S. boulardii is not a target of antibacterial drugs, which is why it can be taken at the same time as each antibiotic dose and why it has become one of the best-studied individual microorganisms for antibiotic-associated diarrhoea. The flip side is that antifungal medicines, such as fluconazole or nystatin, kill it, so the two do not go together.

It is also transient. S. boulardii does not take up residence in the gut. Reviews report that stool levels reach a plateau within about three days of starting and fall to undetectable within days of stopping.^[14] It works while you take it, and that is all it claims to do.

How S. boulardii works: the proposed mechanisms

Nobody has watched S. boulardii work inside a human gut, so what follows is mechanism from laboratory and animal studies, summarised in the Kelesidis and Pothoulakis review, set against the clinical outcomes that have actually been measured.^[14]

S. boulardii and antibiotics: the diarrhoea evidence

This is the use that justifies the shelf space. Antibiotic-associated diarrhoea affects a sizeable minority of people on a course, which is why the HSE lists diarrhoea among the common side effects of antibiotics and advises contacting your GP if it occurs.^[16] S. boulardii is one of the best-studied individual microorganisms for it.

The studies, one by one

S. boulardii and C. diff

Clostridioides difficile (C. diff) is the bacterium behind the most serious form of antibiotic-associated diarrhoea, and the HSE antibiotics page names it as a cause of diarrhoea that can be severe.^[16] The toxin-degrading protease is the mechanism that drew researchers to S. boulardii for C. diff. Two adjunctive trials from the 1990s reported a signal in recurrent disease, probiotics as a class reduce C. difficile diarrhoea during antibiotics in the Cochrane pooled analysis, and yet the current American gastroenterology guidelines advise against probiotics for both primary and recurrence prevention. All three facts belong in the same paragraph.^[4]

Travellers' diarrhoea, children's gastroenteritis and H. pylori

Three further uses have pooled trial data. Travellers' diarrhoea was the first of them to be meta-analysed, in 2007, when S. boulardii was one of only two probiotics to show an effect.^[6]

SIBO, candida and IBS: where the claims outrun the evidence

"Saccharomyces boulardii SIBO" and "S. boulardii candida" are two of the most-searched phrases about this yeast in Ireland. Both uses appear in practitioner protocols and on supplement sites. Here is what has been tested.

What medical guidelines say about S. boulardii

Sources: ESPGHAN 2016 (PMID 26756877) and 2023 (PMID 36219218); ACG 2021 (Kelly et al.); AGA 2026 (Fischer et al., PMID 42383946); HSE antibiotics page. No Irish or EU clinical guideline specific to S. boulardii was identified.

Dosage: how and when to take S. boulardii

The trial doses are unusually consistent for a probiotic: 250 mg to 1,000 mg a day of freeze-dried S. boulardii. Trials reported mass; retail labels report viable count (CFU), and the relationship between the two varies by product, so compare like with like. Most antibiotic-associated diarrhoea trials used 500 mg to 1,000 mg a day in adults; ESPGHAN suggests 250 to 500 mg a day for children.^[3] The Surawicz C. difficile trial used 1 g a day for 28 days.^[5] There is no established optimal dose and no dose-finding trial in adults; follow the label of the product you have.

NOW Foods Saccharomyces Boulardii: the manufacturer's label gives 5 billion CFU per capsule, a serving of two capsules (10 billion), and directions of one to two capsules, two to three times daily, between meals, as needed. That range runs from 5 to 30 billion a day, so the lower end fits the typical trial dose and the upper end exceeds it. Two capsules twice a day during an antibiotic course would sit in the middle of what was tested.

Jarrow Formulas Saccharomyces Boulardii + MOS: 250 mg of S. boulardii (5 billion CFU) plus 200 mg of MOS (mannan-oligosaccharides, a yeast-derived prebiotic) per capsule, directions one capsule daily. One a day is the low end of the trial range and the ESPGHAN paediatric suggestion; adults in the diarrhoea trials usually took two to four times that.

With or without food?

No trial has compared the two. Yeast tolerates stomach acid better than most probiotic bacteria, which is why timing matters less than it does for a Lactobacillus. NOW's label says between meals; Jarrow's gives no instruction. Pick one approach and keep to it. The practical question people actually mean is "do I space it from the antibiotic?", and for S. boulardii the answer is no: it is not harmed by antibacterial antibiotics, so take it with the dose if that helps you remember. The exception is any antifungal medicine, which will kill it, so the two should not be taken together at all.

When to start and how long to take it

Side effects, who must not take it, medicines and pregnancy

In the randomised trials in otherwise healthy adults and children, S. boulardii was well tolerated. McFarland's 2010 review of 27 adult trials recorded no serious adverse events; the common complaints were wind, bloating and occasionally constipation or looser stools.^[1] In the SIBO pilot, 22% of those on S. boulardii alone reported flatulence or diarrhoea.^[11] Some labels list thirst. People with a yeast allergy should not take it.

S. boulardii in Ireland: FSAI status, HSE pathway, VAT

S. boulardii is sold in Ireland by pharmacies, health stores and online retailers as a food supplement. In France and several other EU countries the CNCM I-745 strain is also registered as a medicine, which is one reason the trial base is as large as it is; in Ireland no S. boulardii product is a licensed medicine. Food supplement status sets the rules for what any seller may say. No health claim for S. boulardii, or for any probiotic, is authorised under Regulation (EU) 432/2012, and disease-treatment claims are not permitted for food supplements.^[17] A page that tells you S. boulardii cures C. diff, clears candida or treats SIBO is making a claim that is not permitted for a food supplement.

How to choose an S. boulardii product

Five things matter. This comparison covers the two products sold by Probiotic.ie; details were checked against the manufacturers' published labels and our live listings on 9 November 2026.

1. Dose per capsule and per day. Trials reported dose by mass, 250 mg to 1,000 mg a day of freeze-dried yeast; labels report viable count in CFU, and the two are not interchangeable across products. Both products here declare 5 billion CFU per capsule (Jarrow also states 250 mg); how many you take decides where you land. Combination products that list S. boulardii among ten strains often contain a fraction of a trial dose.

2. Strain. The evidence is overwhelmingly for CNCM I-745. Pharmacy products that declare that strain (sold under various brand names across Europe) carry the evidence directly. The NOW Foods and Jarrow Formulas labels reviewed do not establish that these products contain CNCM I-745, and results from trials of that strain should not automatically be attributed to them. We say that plainly because an evidence guide that did not would be worthless.

3. Viability to end of shelf life. Look for a CFU guarantee "at expiry", not "at manufacture". Freeze-dried S. boulardii is shelf-stable; both NOW and Jarrow state no refrigeration is required, but keep capsules away from heat.

4. What else is in the capsule. NOW adds organic inulin (FOS) and guar gum; Jarrow adds 200 mg MOS. Both are small prebiotic amounts. If you are sensitive to FODMAPs, inulin and MOS can add to wind in the first days.

5. Your own eligibility. If you are in any of the groups in the safety section, the right product is none of them. Ask a pharmacist.

Frequently asked questions

What is Saccharomyces boulardii?

Saccharomyces boulardii is a probiotic yeast, genetically a strain of Saccharomyces cerevisiae, the baker's and brewer's yeast species. It differs from baker's yeast in growing best at 37 degrees Celsius and tolerating stomach acid and bile, as summarised in the Kelesidis and Pothoulakis review (Therapeutic Advances in Gastroenterology, 2012, PMID 22423260). It was first isolated in the 1920s by the French microbiologist Henri Boulard, and the strain he isolated, CNCM I-745, is the one used in most clinical trials. Because it is a yeast and not a bacterium, antibacterial antibiotics do not kill it, which is why it is one of the best-studied individual microorganisms for antibiotic-associated diarrhoea. It does not colonise the gut: it is cleared from the stool within days of stopping. In Ireland it is sold as a food supplement under FSAI rules, not a medicine.

What are the benefits of Saccharomyces boulardii according to the evidence?

The best-supported benefit is a lower risk of antibiotic-associated diarrhoea. Szajewska and Kołodziej (Alimentary Pharmacology and Therapeutics, 2015, PMID 26216624) pooled 21 randomised trials in 4,780 people and found diarrhoea fell from 18.7 percent to 8.5 percent (relative risk 0.47, 95 percent confidence interval 0.38 to 0.57), one case prevented for every 10 people treated. Smaller bodies of evidence show fewer cases of travellers' diarrhoea (relative risk 0.79 for the CNCM I-745 strain; McFarland and Goh 2019, PMID 30278238), about one day less diarrhoea in children with acute gastroenteritis on low-quality evidence (29 trials; Szajewska 2020, PMID 32056266), better Helicobacter pylori eradication and fewer treatment side effects when added to triple therapy (Szajewska 2010, PMID 21039671), and, in two adjunctive trials from the 1990s, fewer Clostridioides difficile recurrences (McFarland 1994, PMID 8201735; Surawicz 2000, PMID 11049785), a finding never confirmed in a larger trial; the ACG (2021) and AGA (2026) guidelines now advise against probiotics for C. difficile prevention. Evidence for SIBO is two small open pilots, the candida evidence in people is one neonatal prevention trial plus laboratory work, and the IBS evidence is one small trial with a quality-of-life signal only. No EU health claim is authorised for S. boulardii and it is a food supplement in Ireland, not a medicine.

Can you take Saccharomyces boulardii with antibiotics?

Yes, and that is its main studied use. Because S. boulardii is a yeast, antibacterial antibiotics do not kill it, so it can be taken at the same time as each antibiotic dose rather than spaced two to three hours apart as bacterial probiotics usually are. In the trials pooled by Szajewska and Kołodziej (2015, PMID 26216624), S. boulardii started with the antibiotic course and ran for its duration, sometimes for a few days beyond, and reduced antibiotic-associated diarrhoea from 18.7 percent to 8.5 percent. The ESPGHAN paediatric guideline (2016, PMID 26756877) makes a strong recommendation for it in children at 250 to 500 mg a day, confirmed in ESPGHAN's 2023 position paper (PMID 36219218). Most trials used the CNCM I-745 strain; the NOW Foods and Jarrow Formulas labels reviewed do not declare that strain. The exception is antifungal medicines such as fluconazole or nystatin, which kill S. boulardii, so the two should not be taken together. If you develop diarrhoea while on an antibiotic, the HSE advises contacting your GP.

Does Saccharomyces boulardii help with C. diff?

The evidence is narrower than the mechanism suggests. In the laboratory S. boulardii secretes a protease that degraded Clostridioides difficile toxins A and B in human colonic tissue (Castagliuolo et al., Infection and Immunity, 1999). In people, two randomised trials added S. boulardii to standard antibiotics: McFarland et al. (JAMA, 1994, PMID 8201735) in 124 adults found a further recurrence in 34.6 percent on S. boulardii against 64.7 percent on placebo among those with recurrent disease, and no significant difference in first episodes; Surawicz et al. (Clinical Infectious Diseases, 2000, PMID 11049785) found recurrence of 16.7 percent against 50 percent, but only in the high-dose vancomycin group (p=0.05). Neither finding was confirmed in a larger trial. The Cochrane review updated in 2025 (Esmaeilinezhad et al., PMID 40931979) found probiotics as a class reduced C. difficile-associated diarrhoea during antibiotics from 4.0 percent to 1.5 percent (one case prevented per 65 people), pooling several probiotics without isolating S. boulardii. Current guidelines are clear: the American College of Gastroenterology (2021) recommends against probiotics for preventing first or recurrent C. difficile infection, and the American Gastroenterological Association's 2026 clinical practice update states probiotics are not advised to prevent an initial or recurrent infection. S. boulardii is not a treatment for C. difficile infection; in the trials it was added to antibiotics, never used instead of them. Suspected C. difficile needs a GP.

Does Saccharomyces boulardii help SIBO?

It is not established. Two small exploratory studies exist, neither placebo-controlled. Bustos Fernández, Man and Lasa (Digestive Diseases, 2023, PMID 36630947) randomised 54 patients with diarrhoea-predominant IBS and a positive breath test to S. boulardii CNCM I-745 plus dietary advice or dietary advice alone for 15 days: breath hydrogen fell 41 percent against 29 percent and fewer patients still had diarrhoea (25.9 percent against 47.6 percent), in an open-label pilot. García-Collinot et al. (Digestive Diseases and Sciences, 2020) compared metronidazole, S. boulardii or both in 40 patients with systemic sclerosis: SIBO eradication was 33 percent with S. boulardii alone, 25 percent with metronidazole alone and 55 percent with both, with no placebo group. Their size and design do not establish S. boulardii as a SIBO treatment, and ESPGHAN's 2023 position paper makes no recommendation for or against probiotics in SIBO. Persistent bloating and bowel symptoms need clinical assessment; S. boulardii should not be used to self-diagnose or treat suspected SIBO.

Does Saccharomyces boulardii kill candida or help with yeast infections?

Not for thrush or yeast infections in adults. In the laboratory, S. boulardii and the capric acid it secretes reduced Candida albicans filamentous growth, adhesion and biofilm formation in culture (Murzyn et al., PLoS ONE, 2010, PMC2919387). The human research is different in kind: one randomised comparison in 181 premature infants in neonatal intensive care (Demirel et al., European Journal of Pediatrics, 2013, PMID 23703468) tested S. boulardii against the antifungal nystatin for preventing fungal colonisation and invasive fungal infection in that high-risk hospital population. That is prevention in a specialist setting, not treatment, and it does not show that retail S. boulardii supplements treat adult oral or vaginal thrush or symptoms attributed to candida overgrowth. No treatment trial for thrush or intestinal candida in adults was identified. S. boulardii is itself a yeast but is not a Candida species and does not cause thrush in healthy people; however it has caused bloodstream yeast infections in immunocompromised and critically ill patients and in people with a central venous catheter, who should not take it. Thrush and recurrent yeast infections are treated with antifungal medicines from a pharmacist or GP, and antifungals kill S. boulardii, so the two should not be combined.

What is the dosage of Saccharomyces boulardii?

Clinical trials used 250 mg to 1,000 mg of freeze-dried S. boulardii a day. Retail labels report viable count in CFU rather than mass, and the relationship between the two varies by product, so compare like with like. Most antibiotic-associated diarrhoea trials in adults used 500 to 1,000 mg a day, the ESPGHAN paediatric guideline (2016, PMID 26756877) suggests 250 to 500 mg a day for children, and the Surawicz C. difficile trial used 1 g a day for 28 days. No optimal dose has been established. Follow the label of the product you have. The NOW Foods Saccharomyces Boulardii label gives 5 billion CFU per capsule with directions of one to two capsules, two to three times daily between meals, as needed; the Jarrow Formulas Saccharomyces Boulardii + MOS label gives 250 mg (5 billion CFU) plus 200 mg MOS per capsule, one capsule daily. Check the label on the pack you receive, as directions can vary between batches and markets.

Should Saccharomyces boulardii be taken with or without food?

No trial has compared the two, so there is no evidence-based answer. Yeast tolerates stomach acid better than most probiotic bacteria, which is why timing relative to meals matters less for S. boulardii than for a Lactobacillus product. The NOW Foods label directs taking it between meals; the Jarrow Formulas label gives no instruction. The question people usually mean is whether to space it from the antibiotic, and for S. boulardii the answer is no: antibacterial antibiotics do not harm it, so it can be taken with the antibiotic dose. It should not be taken alongside antifungal medicines, which kill it.

What are the side effects of Saccharomyces boulardii and who should not take it?

In randomised trials in otherwise healthy adults and children S. boulardii was well tolerated; McFarland's 2010 review of 27 adult trials (PMID 20458757) recorded no serious adverse events, and the usual complaints were wind, bloating and occasionally constipation or looser stools. In one pilot, 22 percent of those taking it reported flatulence or diarrhoea. Some labels list thirst. People with a yeast allergy should not take it. The serious risk is fungemia, a bloodstream yeast infection: Enache-Angoulvant and Hennequin (Clinical Infectious Diseases, 2005) reviewed 92 invasive Saccharomyces infections and found 51.3 percent involved S. boulardii probiotic use, mostly in patients with an intravascular catheter and on antibiotics. S. boulardii should not be taken by anyone who is immunocompromised, critically ill or in intensive care, premature, or who has a central venous catheter such as a PICC or Hickman line, and ESPGHAN also lists structural heart disease as a caution group. Capsules should not be opened near such patients or their lines.

Is Saccharomyces boulardii better than a bacterial probiotic?

They do different jobs, so neither is simply better. S. boulardii is a yeast that is not targeted by antibacterial antibiotics and is one of the best-studied individual microorganisms for preventing antibiotic-associated diarrhoea (21 trials; Szajewska and Kołodziej 2015, PMID 26216624). Bacterial probiotics such as Lactobacillus rhamnosus GG also have evidence for antibiotic-associated diarrhoea and ESPGHAN (2016 and 2023) recommends either organism for children, while multi-strain bacterial formulas have the larger evidence base for conditions such as IBS, ulcerative colitis and pouchitis. S. boulardii does not replace the resident bacteria suppressed by an antibiotic; it is cleared within days of stopping. Some people use S. boulardii during the antibiotic course and a bacterial probiotic afterwards; no trial has tested that sequence directly.

Is Saccharomyces boulardii legal in Ireland?

Yes. S. boulardii capsules are sold in Ireland by pharmacies, health stores and online retailers as food supplements under FSAI (Food Safety Authority of Ireland) oversight. They are not medicines and no S. boulardii product is licensed by the HPRA, although the CNCM I-745 strain is registered as a medicine in France and some other EU countries. No health claim for S. boulardii or any probiotic is authorised under Regulation (EU) 432/2012 and disease-treatment claims are not permitted for food supplements, so no retailer may claim it treats C. difficile, SIBO, candida or any other condition. Food supplements in Ireland carry 13.5 percent VAT, confirmed in the Revenue Tax and Duty Manual on food supplement products.

Where can I buy Saccharomyces boulardii in Ireland?

Probiotic.ie, a Dublin-based Irish retailer, stocks NOW Foods Saccharomyces Boulardii (60 vegetarian capsules, 5 billion CFU per capsule, shelf-stable) and Jarrow Formulas Saccharomyces Boulardii + MOS (90 capsules, 5 billion CFU plus 200 mg MOS per capsule, vegan, shelf-stable), both shipped from Dublin with tracked nationwide delivery across Ireland. Because orders ship from within Ireland there are no customs or import charges. S. boulardii is also sold by Irish pharmacies and health stores, some carrying products that declare the CNCM I-745 strain used in most trials. All are food supplements regulated under FSAI guidelines with 13.5 percent VAT.

Related guides

This guide is for educational purposes only and does not constitute medical advice. NOW Foods Saccharomyces Boulardii and Jarrow Formulas Saccharomyces Boulardii + MOS are food supplements regulated under FSAI guidelines and are not medicines; they are not intended to diagnose, treat, cure or prevent any disease or medical condition, including Clostridioides difficile infection, SIBO, candida infection, IBS or travellers' diarrhoea. Do not take Saccharomyces boulardii if you are immunocompromised, critically ill or have a central venous catheter. If you develop diarrhoea while taking an antibiotic, or diarrhoea with blood, fever, severe pain or signs of dehydration, contact your GP. Probiotic.ie is regulated under FSAI food supplement guidelines.

Sources

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27. Kovacevic P, Mrdja V, Kovacevic T, Mrdja J, Soldatovic I, Rajkovaca Z. Saccharomyces boulardii for the prevention of antibiotic-associated diarrhea in hospitalized patients receiving antibiotics: a single-center, randomized, double-blind, placebo-controlled trial. Antibiotics. 2026;15(9):868. DOI 10.3390/antibiotics15090868. — doi.org/10.3390/antibiotics15090868