Indications and dosage for ­Mutaflor and Mutaflor Suspension

­Mutaflor – therapeutic indications

  • chronic constipation
  • Ulcerative colitis in the remission stage

Mutaflor – dose recommendation

Adolescents and adults take 1 capsule ­Mutaflor daily from day 1 to 4, then 2 capsules daily.
In case of persistent constipation, a daily intake of up to 4 capsules ­Mutaflor might be reasonable.
Patients should take ­Mutaflor as a long-term therapy in case of ulcerative colitis to maintain remission.

The standard dose should be taken unchewed and with plenty of liquid during a meal, preferably ­breakfast.

Potentially occurring flatulence is invariably a sign of a too high dose application and will mostly disappear when the dose is reduced. The daily dose of several capsules must not be taken at one time, but may be distributed over the day and taken with regular meals.

Mutaflor Suspension – therapeutic indications

  • Diarrhea in infants, toddlers and children
    (also under under tube feeding)
  • colonization prophylaxis in premature and full-term infants
  • enhancement of postnatal immune competence in premature and full-term infants

Mutaflor ­Suspension – dose recommendation ­


Infants, toddlers and children: 1–3 x 1 ml ­Mutaflor Suspension per day. Up to 5 days in cases of acute diarrhea; up to 15 days in cases of longer persisting diarrhea.

Diarrhea under tube-feeding:

Infants, toddlers and children: 1 x 1–5 ml ­Mutaflor Suspension per day. up to 5 days per period of diarrhea. Therapy should be continued for several days after initial treatment success.

Colonization prophylaxis:

For colonization prophylaxis and enhancement of immune competence, ­Mutaflor should be applied as near as possible to the date of birth, for example, in the scope of a U1 examination.
On the following days, application is recommended in the morning before first drinking.

Premature and full-term infants: 1 x 1 ml per day

Enhancement of postnatal immune competence:

Premature and full-term infants: First week of life: 1 x 1 ml per day; Second to third week of life: 1 ml per day, 3-times a week

Antibiotic sensitivity of E. coli strain Nissle 1917

As a bacterial isolate from the pre-antibiotic era, E. coli strain Nissle 1917 (Mutaflor) is sensitive to all antibiotics  which are predominately directed against Gram-negative bacteria, e. g. coli bacteria.
A certain loss of ­Mutaflor-efficacy must be taken into account. Nevertheless, a protective ­Mutaflor-therapy should be initiated in addition to antibiotic therapy.

– Amikacin, Amoxicillin/Clavulanic acid, Ampicillin, Azlocillin
– Cefaclor, Cefazolin, Cefoperazone, Cefotaxime, Ceftriaxone, Cephalotin, Chloramphenicol, Ciprofloxacin
– Doxycycline
– Gentamicin
– Latamoxef
– Mezlocilin
– Nitrofurantoin, Norfloxacin
– Pipemidic acid, Piperacillin
– Tetracycline, Ticarcillin, Tobramycin, Trimethoprim
– Sulfamethoxazole

Combination with antibiotics – natural antibiotic resistance of E. coli strain Nissle 1917

­Mutaflor is not sensitive to antibiotics which are predominately directed against Gram-positive bacteria. That is why EcN may be combined with these ­antibiotics.

– Cefsulodin, Clindamycin
– Erythromycin
– Metronidazole
– Penicillin G
– Quinupristin/Dalfopristin
– Rifampin
– Teicoplanin
– Vancomycin

Mutaflor international package insert to download
Mutaflor Suspension international package insert to download