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 < 0.001). 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.