What Probiotics Are Good For Klebsiella Pneumoniae?

December 19, 2025 •

5 min read

According to the Centers for Disease Control and Prevention (CDC), multidrug-resistant Klebsiella pneumoniae is a serious threat to human health, especially in hospital settings. While antibiotics remain the primary treatment, research is exploring which probiotics are good for Klebsiella pneumoniae by inhibiting its growth and restoring microbiome balance.

Quick Summary

This guide examines specific probiotic strains, including certain Lactobacillus and Bifidobacterium species, and how their antimicrobial properties may help manage Klebsiella pneumoniae overgrowth and biofilm formation. It also addresses safety precautions and the importance of medical consultation.

Key Points

Lactobacillus and Bifidobacterium Strains: Specific strains from these genera, like L. plantarum LP1812 and B. longum FB1-1, have shown inhibitory effects against Klebsiella pneumoniae in preclinical studies.
Multiple Mechanisms: Probiotics combat Klebsiella by producing antimicrobial compounds (e.g., lactic acid, acetic acid), competing for resources, and inhibiting biofilm formation.
Biofilm Disruption: The ability of some probiotics to break down Klebsiella biofilms is particularly important, as these structures protect the bacteria from antibiotics.
Supports Antibiotic Therapy: In some studies, probiotics used alongside antibiotics showed better outcomes than antibiotics alone, potentially reducing antibiotic duration and minimizing resistance.
Requires Medical Consultation: Probiotics can pose risks for immunocompromised or critically ill patients. Always consult a healthcare professional before starting treatment, as evidence is primarily from preclinical research.
Not a Replacement for Medical Treatment: Probiotics are not a substitute for standard antibiotic treatment prescribed by a doctor for a diagnosed Klebsiella infection. They are being explored as a supportive measure.

Understanding Klebsiella Pneumoniae and the Microbiome

Klebsiella pneumoniae is an opportunistic, gram-negative bacterium that naturally resides in the human intestines. While harmless in a balanced gut, it can cause severe, life-threatening infections—including pneumonia and urinary tract infections (UTIs)—when it overgrows or enters other parts of the body. A major challenge in treating Klebsiella infections is the bacterium's increasing resistance to antibiotics, leading to high mortality rates and limited therapeutic options. This is largely due to the rapid spread of genes that confer resistance, especially within hospital environments.

The gut microbiome plays a crucial role in preventing pathogenic overgrowth. When the microbial balance is disrupted by factors like antibiotic use or diet, a condition known as gut dysbiosis occurs. This allows opportunistic bacteria like Klebsiella pneumoniae to proliferate and form resilient biofilms, further complicating treatment. A primary goal of probiotic therapy is to restore a healthy microbial balance, thereby preventing overgrowth and strengthening the body's natural defenses against pathogens.

How Probiotics Counteract Klebsiella

Probiotics, or beneficial bacteria, employ several mechanisms to inhibit the growth and virulence of Klebsiella pneumoniae:

Competitive Exclusion: Probiotic strains compete with Klebsiella for nutrients and adhesion sites on the intestinal or mucosal lining, effectively preventing the pathogen from colonizing.
Antimicrobial Production: Many probiotic species, particularly Lactobacillus, produce substances such as organic acids (lactic and acetic acid), hydrogen peroxide, and bacteriocins. These compounds lower the local pH and create a hostile environment for Klebsiella, inhibiting its growth.
Biofilm Disruption: Biofilms are protective bacterial communities that are highly resistant to antibiotics. The cell-free supernatant (CFS) from certain probiotic strains has been shown to prevent Klebsiella pneumoniae biofilm formation and even eradicate existing biofilms.
Immune Modulation: Some probiotics, like Bifidobacterium longum, can activate host immune responses that help fight infection. This includes inducing a protective inflammatory response and promoting a faster return to homeostasis after infection.
Gene Regulation: Research has demonstrated that probiotic CFS can downregulate the expression of key genes associated with antibiotic resistance (e.g., bla_KPC) and virulence (e.g., fim_H) in Klebsiella. This may make Klebsiella less harmful and more susceptible to treatment.

Key Probiotic Strains for Klebsiella Management

Multiple strains from different probiotic genera have shown potential against Klebsiella pneumoniae in laboratory or animal studies. Some of the most promising candidates include:

Lactobacillus plantarum: A specific strain, L. plantarum LP1812, was shown in a mouse model to effectively clear carbapenem-resistant Klebsiella pneumoniae (CRKP) from the gut. The inhibitory effect was linked to the production of acetic acid, which can acidify the pathogen's intracellular environment.
Lactobacillus rhamnosus: Studies using mouse models and in vitro tests have demonstrated that L. rhamnosus can be effective as a supportive or curative treatment against K. pneumoniae, sometimes in combination with antibiotics. Different strains, such as L. rhamnosus B-445, have shown significant growth inhibition.
Lactobacillus casei: Research involving clinical isolates from UTI patients found that L. casei exhibited notable antimicrobial effects against K. pneumoniae, producing significant growth inhibition zones.
Lactobacillus helveticus: Strains isolated from kefir have demonstrated strong anti-biofilm activity against multidrug-resistant (MDR) K. pneumoniae. Its cell-free supernatant can prevent the bacteria from attaching and forming complex biofilms.
Bifidobacterium longum: The cell-free supernatant from a B. longum strain (FB1-1) was found to have a significant inhibitory effect on CRKP, downregulating resistance genes and inhibiting plasmid transfer in laboratory experiments.
Combined Probiotic Therapy: Some studies indicate that combining multiple probiotic species (e.g., Lactobacillus and Bifidobacterium) can have a greater inhibitory effect than single strains alone, often enhanced by the addition of prebiotics.

Comparison of Probiotic Strains for Klebsiella Inhibition


Probiotic Strain	Mechanism of Action	Context of Evidence	Notes on Effectiveness
Lactobacillus plantarum LP1812	Acetic acid production, competitive exclusion, gut microbiota modulation	Mouse model (in vivo) and laboratory (in vitro)	Promising for gut decolonization of CRKP.
Lactobacillus rhamnosus B-445	Production of antimicrobial metabolites	Laboratory (in vitro)	Effective at inhibiting growth of MDR K. pneumoniae.
Lactobacillus casei	Production of antimicrobial compounds, including organic acids	Laboratory (in vitro), human UTI isolates	Strong potential as an adjunctive treatment for UTIs.
Lactobacillus helveticus	Anti-biofilm activity, competition for resources	Laboratory (in vitro)	Effective against MDR K. pneumoniae biofilm formation.
Bifidobacterium longum FB1-1	Downregulation of resistance/virulence genes, organic acid production	Laboratory (in vitro)	Shows potential for inhibiting CRKP gene expression and plasmid transfer.
Multi-species combinations	Synergy of multiple mechanisms	Laboratory (in vitro) and animal models	Often more effective than single strains.

Important Safety Considerations

While probiotics are generally regarded as safe, they are not without risks, especially for certain individuals. Patients who are critically ill, have weakened immune systems (e.g., due to chemotherapy or other conditions), or have recently undergone surgery should exercise extreme caution. There are reports of immunocompromised patients developing infections from probiotic bacteria, including species like Lactobacillus rhamnosus.

It is crucial to understand that the research on probiotics and Klebsiella is largely preclinical (in vitro or animal studies). Results from these studies do not always translate directly to human clinical outcomes, and some human trials have shown conflicting results. Therefore, probiotics should never be used as a replacement for conventional antibiotic therapy prescribed by a doctor.

How to Discuss Probiotics with Your Doctor

If you are considering probiotics, especially in the context of a Klebsiella infection or overgrowth, discuss it with your healthcare provider. They can help you determine the following:

Appropriateness: Whether probiotics are safe and potentially beneficial for your specific health condition.
Strain and Dosage: Recommend a specific, clinically validated strain and the appropriate dosage. Not all probiotics are created equal, and strain-specific effects are key.
Timing: Advise on the best timing, especially if you are also taking antibiotics, as the timing can affect efficacy.

Conclusion

While antibiotics remain the standard treatment for serious Klebsiella pneumoniae infections, preclinical research suggests that certain probiotic strains, particularly from the Lactobacillus and Bifidobacterium genera, hold promise as a complementary therapy. These beneficial bacteria can inhibit Klebsiella's growth, disrupt its biofilms, and modulate the host's immune response through multiple mechanisms. They show potential for managing gut colonization and addressing the growing problem of antibiotic resistance. However, the use of probiotics, particularly in cases involving compromised immune systems, requires careful medical supervision due to potential risks. Always consult a healthcare professional before starting any probiotic regimen to ensure it is safe and appropriate for your individual needs. For more information on research and antibiotic resistance, you can visit the NCBI website(https://www.ncbi.nlm.nih.gov/books/NBK519004/).

Frequently Asked Questions

You should only do so under the guidance of a healthcare professional. Some research suggests that certain probiotics may be used alongside antibiotics to support recovery and reduce side effects, but the timing and specific strain are crucial. Your doctor can determine the right course of action for your specific infection and health status.

Preclinical research has identified several promising strains, including Lactobacillus plantarum LP1812, Lactobacillus rhamnosus, Lactobacillus helveticus, Lactobacillus casei, and Bifidobacterium longum FB1-1. The effectiveness and application can depend on the specific infection type (e.g., gut vs. UTI).

Probiotics are generally considered safe for healthy individuals. However, caution is advised for those who are critically ill or immunocompromised, as there are case reports of infections arising from probiotic use in this population. Always consult a doctor first, especially if you have an active infection.

Probiotics can help by competing with Klebsiella for nutrients and space, producing antimicrobial substances like organic acids that inhibit its growth, and restoring overall balance to the gut microbiome. Maintaining a healthy microbiome helps keep opportunistic pathogens like Klebsiella in check.

Some in vitro and animal studies have shown that certain probiotic strains, and their cell-free supernatants, can inhibit carbapenem-resistant Klebsiella pneumoniae (CRKP) by disrupting biofilms, lowering pH, and potentially downregulating resistance genes. This research is promising but requires further human clinical studies.

Research has shown that probiotics can help prevent colonization in some cases. For instance, studies in mice found that certain Lactobacillus species were associated with decreased Klebsiella levels in the feces. However, their use for prevention needs more evidence from human trials.

A synbiotic is a combination of probiotics and prebiotics (non-digestible fibers that feed beneficial bacteria). Some studies indicate that certain synbiotic formulations can enhance the inhibitory effect against Klebsiella, as the prebiotics can boost the activity of the beneficial strains.