Effect of Probiotics Supplementation on Clinical, Humanistic, and Safety Outcomes in Patients With Tuberculosis: A Prospective Cohort Study in a Tertiary Healthcare Facility in South India

Objective This study aimed to assess the effect of probiotic supplementation on multiple dimensions of tuberculosis (TB) care, including clinical, humanistic, and safety outcomes. Method This study is a prospective cohort study. Data were collected for TB treatment outcome, hematologic inflammatory indices, anti-tuberculosis treatment (ATT)-induced adverse drug reactions (ADRs), and health-related quality of life (HRQoL) using EuroQol 5-Dimension 5-level questionnaire to evaluate the effect of probiotics supplementation. Results In all, 177 patients with drug-sensitive pulmonary TB were enrolled. TB treatment success rates in the study group (SG) and the reference group (RG) were 85.1% and 84.6%, respectively ( p = 1.000). Among hematologic inflammatory indices, only the systemic inflammation response index (SIRI) showed a statistically significant reduction after probiotic supplementation ( p = 0.048). No significant changes were observed in HRQoL scores at various time points. ATT-induced ADRs were significantly lower in the SG than the RG (14.8% vs 61.3%; p Conclusion Probiotic supplementation did not significantly influence TB treatment success or HRQoL outcomes. However, it showed a favorable impact on systemic inflammation and a significant reduction in the incidence of ATT-induced ADRs, especially gastrointestinal side effects. These findings suggest a potential role for probiotics as a supportive adjunct to ameliorate ATT-induced ADRs. Future studies should focus on assessing long-term supplementation effects to investigate humanistic outcomes.