Antibiotics are medications specifically designed to combat bacterial infections by either killing bacteria or inhibiting their growth. These powerful drugs are widely used to treat or prevent various bacterial illnesses. In contrast, probiotics are live microorganisms, primarily bacteria and yeasts, that offer health benefits when consumed in adequate amounts. They are often found in fermented foods like yogurt or taken as dietary supplements. A common question arises regarding the simultaneous use of antibiotics and probiotics.
Taking Antibiotics and Probiotics Concurrently
Taking antibiotics and probiotics concurrently is generally considered safe and often recommended. Antibiotics target harmful bacteria but can also disrupt beneficial bacteria in the gut, known as the gut microbiota. This disruption can lead to side effects, with antibiotic-associated diarrhea (AAD) being common. AAD can affect up to 35% of individuals taking antibiotics.
Probiotics can help mitigate these side effects by supporting the balance of gut flora. Research suggests that taking probiotics with antibiotics can reduce the risk of AAD by approximately 50% in both children and adults. They achieve this by various mechanisms, including modulating the gut microbiome, increasing gut barrier integrity, and producing antimicrobial substances. Probiotics may also help reduce the chance of developing Clostridioides difficile (C. diff) colitis, an inflammation of the colon often triggered by antibiotic use.
The scientific consensus largely supports this practice, with studies indicating that probiotics can effectively prevent and treat AAD in patients receiving a wide range of antibiotics. For instance, a meta-analysis of over 11,000 participants found that probiotics reduced the relative risk of AAD. Another review of studies in children showed a protective effect of probiotics in preventing diarrhea. Broader and more rigorous research consistently demonstrates the benefits of combining probiotics with antibiotics for gut health protection and quicker recovery.
Maximizing Probiotic Effectiveness with Antibiotics
To maximize probiotic effectiveness with antibiotics, timing is a significant consideration. It is generally recommended to take probiotics a few hours before or after the antibiotic dose. This separation, often at least two hours, helps prevent the antibiotic from killing the probiotic bacteria, allowing them to colonize the gut effectively. Some specific probiotic strains, such as Saccharomyces boulardii and certain Lactobacillus strains, have shown resilience and can be taken concurrently with antibiotics.
Certain probiotic strains have been extensively researched for AAD prevention. Lactobacillus rhamnosus GG and Saccharomyces boulardii are among the most well-documented and effective choices for this purpose. These strains have demonstrated efficacy in restoring gut flora balance and reducing the risk of antibiotic-related diarrhea. Other beneficial strains include Lactobacillus acidophilus Rosell-52, Lactobacillus rhamnosus Rosell-11, and Bifidobacterium lactis Lafti B94, which have been shown to survive alongside antibiotics.
Regarding dosage, a typical daily probiotic dose for adults ranges from 10 to 20 billion colony-forming units (CFUs), while for children, it is often 5 to 10 billion CFUs. Higher doses, between 20 to 40 billion CFUs, may be beneficial for individuals on prolonged antibiotic therapy or those at higher risk for severe gastrointestinal issues. It is generally advisable to start probiotics on the same day as the antibiotic and continue throughout the entire antibiotic course. Many healthcare professionals suggest continuing probiotic use for at least one to several weeks after finishing the antibiotic course to help fully restore the gut microbiome. For personalized advice on specific strains, dosages, and duration, consulting a healthcare professional is recommended.