Should you take probiotics when taking antibiotics?
The question of whether to take probiotics when taking antibiotics is a hot topic right now. There is research for and against. Overall, there is more research for taking probiotics than against it.
Understanding the Interaction: Antibiotics are designed to eradicate pathogenic bacteria, but they can inadvertently affect commensal (healthy or beneficial) microorganisms residing in the gastrointestinal tract. This disruption may lead to gastrointestinal symptoms such as diarrhea, as well as the overgrowth of opportunistic pathogens like Clostridium difficile. Probiotics, by introducing beneficial bacteria, aim to restore microbial balance and alleviate these adverse effects.
Guidelines for Co-Administration: Several guidelines offer recommendations regarding the use of probiotics alongside antibiotics. The World Health Organization (WHO) suggests considering probiotics for specific populations, such as infants and children receiving antibiotics or individuals at high risk of antibiotic-associated diarrhea. Anyone with a history of taking antibiotics (like me), having more than one course of antibiotics, and/or those who experience gastrointestinal distress when taking antibiotics may also benefit from simultaneous probiotic dosing.
Strain Specific: Some probiotic strains are better than others for this particular situation. Lactobacillus rhamnosus GG and Saccharomyces boulardii, are best for reducing the incidence and severity of antibiotic-associated diarrhea.
Considerations for Special Populations: While probiotics are generally safe for most individuals, certain groups may require special considerations:
Immunocompromised Patients
Individuals with Specific Medical Conditions: Certain medical conditions, such as pancreatitis or short bowel syndrome, may necessitate tailored approaches to probiotic supplementation. Patients with preexisting gastrointestinal disorders should consult their healthcare providers before initiating probiotics.
Timing and Dosage: To minimise interference with antibiotic efficacy, it is generally recommended to administer probiotics at least two hours apart from antibiotic doses. However, something is better than nothing. If you can’t separate the dose, then take them together.
I also recommend you take probiotics for several weeks following antibiotics, usually for a month following a 7-10 day course of antibiotics.