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Mutaflor is a probiotic pharmaceutical containing the live, non-pathogenic strain *Escherichia coli* Nissle 1917 (EcN). [2, 5] First isolated in 1917, it is one of the most extensively studied probiotics worldwide. [1] Mutaflor is used for the treatment and management of various gastrointestinal disorders, most notably for maintaining remission in ulcerative colitis and for managing chronic constipation. [3, 7, 8] It is available as enteric-coated capsules and a suspension for oral use. [2, 7] The mechanism of action is multifaceted, involving the modulation of the gut microbiome, competitive exclusion of pathogens, production of antimicrobial substances, enhancement of the intestinal barrier function, and immunomodulatory effects, including the down-regulation of pro-inflammatory cytokines. [1, 2, 5] Clinical studies have shown its efficacy in maintaining remission in ulcerative colitis is comparable to standard mesalamine therapy. [15] The drug is developed and manufactured by Ardeypharm. [14]
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