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**Pro-Symbioflor** is an orally administered, nonviable bacterial lysate containing autolyzed, heat-killed cells and cell fractions from *Escherichia coli* DSM 17252 and *Enterococcus faecalis* DSM 16440. It is a microbiological immunomodulatory medicinal product developed and manufactured by SymbioPharm. The product has been available since 1954 and has been described as an approved drug in Germany and Switzerland. It has been used for gastrointestinal disorders including irritable bowel syndrome, and was evaluated in a phase IV placebo-controlled trial in irritable bowel syndrome that did not demonstrate a statistically significant benefit versus placebo. It was also studied as an early-life oral intervention for prevention of atopic dermatitis; initial subgroup findings suggested reduced infant atopic dermatitis, but school-age follow-up did not demonstrate prevention of atopic dermatitis, asthma, allergic rhinitis, or allergic sensitization. ([sciencedirect.com](https://www.sciencedirect.com/science/article/pii/S1542356521006923))
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