Antibiotics are powerful medicines that combat bacterial infections by targeting and eliminating harmful bacteria. Probiotics, in contrast, are live microorganisms, often beneficial bacteria, that can provide health advantages when consumed. This article explores the relationship between antibiotics and probiotics, offering insights into their combined use.
The Impact of Antibiotics on Gut Flora
The human gut hosts a complex community of microorganisms, known as the gut microbiome. This intricate ecosystem plays a role in digestion, nutrient absorption, and immune system function. A balanced gut microbiome is associated with overall health.
Antibiotics, while effective at eliminating disease-causing bacteria, are often broad-spectrum, meaning they do not selectively target only harmful pathogens. They can also diminish beneficial bacteria within the gut, leading to a reduction in microbial richness and diversity. This disruption is frequently referred to as dysbiosis, an imbalance in the gut’s microbial community. This unintended consequence can alter metabolic activity and increase the gut’s susceptibility to colonization by less desirable organisms.
The Role of Probiotics During Antibiotic Treatment
Introducing probiotics can help mitigate some negative effects antibiotics have on the gut. Probiotics function by introducing beneficial microorganisms, which can help support the balance of gut bacteria during antibiotic therapy.
One notable benefit is the reduction of antibiotic-associated diarrhea (AAD), a common side effect. Probiotics may decrease the risk of AAD by approximately 50% in both children and adults. They can also help lower the chance of developing Clostridioides difficile (C. diff) colitis, a more severe inflammation of the colon often triggered by antibiotic use. These beneficial microorganisms may help by occupying space and resources in the gut, thereby limiting the growth of opportunistic pathogens like C. diff.
Best Practices for Taking Probiotics and Antibiotics
It is generally recommended to begin taking a probiotic supplement when starting the antibiotic course and to continue throughout its duration. Starting probiotics early, ideally within 24 to 48 hours of the first antibiotic dose, appears to offer greater benefits.
A separation of doses is advised to prevent the antibiotic from immediately killing the beneficial bacteria in the probiotic supplement. Taking the probiotic at least two to three hours before or after the antibiotic dose allows each to work more effectively. After completing the antibiotic course, continuing the probiotic for at least a few weeks is often suggested to support the gut microbiome’s recovery. Some individuals may choose to continue probiotic use long-term for ongoing gut health support.
Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii are two of the most studied strains for preventing AAD. Certain Bifidobacterium species, such as B. longum BB536, have also been researched for maintaining gut regularity and resilience during antibiotic exposure. Some multi-strain products containing combinations like Lactobacillus acidophilus Rosell-52, Lactobacillus rhamnosus Rosell-11, and Bifidobacterium lactis Lafti B94 have shown promise in clinical trials, with some even formulated to be taken concurrently with antibiotics.
Selecting a Probiotic Supplement
Choosing an effective probiotic supplement involves understanding key label information. Look for products that clearly list Colony Forming Units (CFUs), which indicate the number of live microorganisms in each dose. While a higher CFU count often suggests a more potent product, a range between 1 billion to 10 billion CFUs per serving is generally considered effective for general health maintenance. For specific concerns like recovering from illness, higher doses, such as 25 billion to 100 billion CFUs daily, might be recommended.
It is also important to identify the specific probiotic strains present, which are typically listed by genus, species, and an alphanumeric strain designation (e.g., Lactobacillus rhamnosus GG). Different strains have varying effects, so selecting a product with strains clinically studied for the desired health benefit is advisable. Check the expiration date on the packaging, as probiotics contain live organisms whose viability can decline over time. Storage instructions, such as refrigeration versus shelf-stable options, should also be noted to ensure the probiotics remain effective until consumed.