When prescribed antibiotics, many people worry about digestive side effects. This often leads to questions about whether probiotics can help and if they can be taken together. This article explores the scientific understanding of how antibiotics and probiotics interact.
How Antibiotics and Probiotics Interact
Antibiotics eliminate or inhibit the growth of infection-causing bacteria. While effective against harmful pathogens, these drugs also affect beneficial bacteria in the gut microbiome. This disruption can lead to an imbalance, reducing microbial diversity within the digestive system.
Probiotics are live microorganisms, such as bacteria or yeasts, that offer health benefits when administered adequately. They support existing microbial communities in the body. Taking probiotics with antibiotics can counteract antibiotic-induced gut microbiome disruption and help restore its natural balance.
The Science Behind Concurrent Use
Research supports taking probiotics concurrently with antibiotics, primarily to mitigate antibiotic-associated diarrhea (AAD). AAD is a common side effect, affecting many patients, and results from antibiotic-induced gut flora imbalance. Probiotics help by replenishing beneficial gut bacteria.
Studies and meta-analyses indicate that co-administering probiotics with antibiotics reduces the risk of AAD. A pooled analysis suggests a 37% reduction in AAD risk in adults when probiotics are taken simultaneously. Probiotics achieve this by:
Boosting immunity.
Increasing gut barrier integrity.
Producing antimicrobial substances.
Modulating the gut microbiome.
This approach is safe and effective for many individuals, particularly those at moderate to high AAD risk.
Practical Guidance for Taking Them Together
To maximize probiotic effectiveness, separate probiotic and antibiotic doses by at least two to three hours. This time gap helps ensure the antibiotic does not immediately kill the beneficial bacteria, allowing them to reach the gut alive.
Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii are well-researched strains effective in mitigating antibiotic side effects. Saccharomyces boulardii is a yeast, making it naturally resistant to antibiotics. Other beneficial strains include Lactobacillus and Bifidobacterium species.
Probiotic use should span the entire antibiotic treatment course and extend for at least one to two weeks afterward. Continuing supplementation for several weeks or months post-treatment can further support gut microbiome recovery, as gut flora takes time to stabilize. Recommended daily dosages range from 5 billion to 40 billion colony-forming units (CFUs), with higher doses potentially more effective for those at higher gastrointestinal risk.
Important Considerations and When to Seek Medical Advice
While generally safe for healthy individuals, probiotics may not be suitable for everyone. Those with compromised immune systems, critical illness, or certain underlying health conditions should use probiotics cautiously. A rare, theoretical risk of infection from live microorganisms exists in these vulnerable populations.
Always consult a healthcare provider before starting any new supplement, especially with prescription medication. A medical professional can offer personalized guidance based on your health status, antibiotic type, and pre-existing conditions. They can also help determine the appropriate probiotic strain and dosage. Seek medical attention for severe or persistent digestive symptoms, fever, or blood in stool while on antibiotics.