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Hickson et al have tried to introduce true scientific method in an area chiefly governed by sales tactics and mass advertising, but it is good to see their admission regarding problems with correct randomisation.1 Perhaps the solution to the dilemma with the differing bottle sizes and shapes could have been solved by the manufacturer providing appropriately labelled active culture and sterilised samples?
Perhaps a more important omission, however, is the seeming lack of any data on treatment with proton pump inhibitors. Since the target population had a mean age of 74, one could safely assume a sizeable proportion of those would be taking antisecretory treatment. Given the physiological gastric pH, and its likely bactericidal effect on the cultures tested, it would have been more than useful to include outcome data for patients taking proton pump inhibitors.
Competing interests: MBK likes the taste of the drink being studied.