Open Label Trial of Nissle 1917

Background: Nissle 1917 is an E. coli based probiotic that has been successfully used in
Europe for close to 100 years to treat largely gastrointestinal disorders like inflammatory
bowel disease, gastroenteritis, and irritable bowel syndrome. In addition to those
disorders, we believe that Nissle 1917 is a promising alternative therapy for prevention of
urinary tract infections in susceptible individuals.

Purpose: The Phase 1 trial will use Nissle 1917 in healthy adult patient volunteers for the
first time in the United States. The investigators will track the frequency and incidence
of side effects and adverse events.

Participants:

20 adult (>21 years of age) healthy volunteers

Protocol:

- Participants will enroll in our trial after a review of medical history and physical.

- Participants will then take 30 day course of Nissle 1917 capsules

- Investigators will telephone participants 1-2 weeks after they have begun the trial to
assess for any side effects or adverse events

- Subjects will also be provided with a diary to record any side effects or adverse
events

- At the end of 30 days, participants will return to clinic for a follow up visit to
discuss any side effects or adverse events experienced during the trial and to return
any unused medication

- Investigators will again telephone all participants 28-35 days following completion of
the study drug again to pose a questionnaire aimed at revealing any side effects or
adverse events.

Inclusion Criteria:

- Healthy adult volunteer of age 21 years or older

Exclusion Criteria:

- Any individual with an active urinary tract infection (UTI)

- Any individual with an acute illness within the past 7 days

- Any individual with neurogenic bladder or with vesicoureteral reflux

- Any individual with any anatomic abnormality, congenital or acquired, of the urinary
tract system

- Any individual with any anatomic abnormality, congenital or acquired, of the
gastrointestinal tract

- Any individual with untreated dysfunctional elimination syndrome

- Immunocompromised patients

- Individuals with a central venous catheter

- Individuals requiring the use of antibiotics, immunomodulatory medications, or other
probiotics

- Any participant with a history of chronic gastrointestinal disease

- Any individual with a chronic uncontrolled medical illness

- Any female of reproductive age who is currently pregnant, breastfeeding, or sexually
active and unwilling or unable to use an acceptable method of contraception.

- Any participant is unable to appropriately take and store medication

- Any individual enrolled in a clinical trial evaluating another investigational agent
in the last 30 days.