Can You Take Probiotics with Antibiotics?

Probiotics are available in various forms such as food items, powders, drinks, and capsules. People often consume probiotic supplements daily to improve their digestion, immunity, and general wellness. But sometimes, to fight infections, their doctor may prescribe antibiotics. Then the question arises — can you take probiotics with antibiotics? Read on to find out more.

Humans host over 100 trillion microbes in their intestines, which are sometimes referred to as "healthy bacteria." These microbes are mainly various strains of bacteria and include some viruses and fungi. Gut microorganisms perform important functions such as assisting in digestion and absorption of food. Additionally, these microbes reduce the risk of diseases such as diabetes, cancer, and cardiovascular diseases.

When humans change their diet, their gut microbes also change within a short period. For instance, switching from a plant-based diet to meat consumption or vice-versa can change gut flora within five days. It is also possible to introduce new strains of bacteria with foods containing probiotics or probiotic supplements.

But what are probiotics? Why are they prescribed? And can one take them simultaneously with antibiotic treatment?

What are probiotics?

Probiotics are live microbes, such as bacteria or yeast, that can be beneficial to various physiological processes. Certain foods such as yogurt, kimchi, or fermented foods are good sources of probiotics. However, it may not be convenient to consume these food items every day so many people take probiotics in powder, capsule, or drink format that are available over the counter at various pharmacies. For certain conditions, doctors may prescribe probiotic therapy.

Antibiotics and their side effects

Antibiotics are some of the most prescribed drugs. You may have heard about antibiotics such as penicillin, amoxicillin, and azithromycin, which are prescribed for fighting bacterial infections such as ear or throat infections. Some antibiotics kill bacteria while others limit bacterial growth and allow the body to fight infections.

Antibiotics are often useful in fighting the infection, but people may experience certain side effects. Along with disease-causing bacteria, antibiotics can kill healthy bacteria in the gut and as a result, people have symptoms such as diarrhea. Approximately 35% of people taking antibiotics report antibiotic-associated diarrhea. This antibiotic-associated diarrhea can lead to prolonged illness, hospitalization, and death if left untreated. Clostridium difficile infection can lead to pseudomembranous colitis (inflammation of the intestines), which may result in death.

Probiotics help reduce the side effects

Prescribing probiotics along with antibiotics prevents antibiotic-associated diarrhea. Probiotics establish a balance of various healthy bacteria in the gut and reduce disease-causing bacteria. Probiotic therapy is usually easy to administer (capsules or drinks) and inexpensive compared to the expenses of hospitalization to treat antibiotic-associated diarrhea.

Research has shown that taking probiotics along with antibiotics and for an additional seven days proves to be beneficial to the patient. In some cases, only a high dose of probiotics i.e., 10 billion CFU per day, may be effective. Most common probiotics contain bacterial strains such as:

• Lactobacillus acidophilus
• Saccharomyces boulardii
• Bifidobacterium longum
• Streptococcus thermophilus
• Lactobacillus casei

The composition of gut bacteria depends on various factors such as diet, genes, and environment, so doctors may prescribe probiotic therapy containing specific strains of bacteria. Given these nuances of probiotic therapy, it is beneficial to consult a doctor before you start taking probiotics.

IBS and probiotics

In diseases such as irritable bowel syndrome (IBS), probiotics have proven to be beneficial. In IBS, one of the pathological factors is small intestinal bacterial overgrowth. If left untreated, this overgrowth can affect the digestion of carbohydrates, vitamins, and other minerals. It leads to symptoms such as weight loss and inflammation. Doctors usually prescribe antibiotics to reduce this overgrowth of bacteria.

However, eradicating bacterial overgrowth is only the first step. It is also necessary to introduce healthy microbes in the gut that help in digestion. Probiotic therapy can help in reducing symptoms such as bloating, abdominal pain, and diarrhea. Probiotic therapy is strain dependent, meaning patients need specific probiotics based on their individual clinical symptoms and history.

Precision medicine

Today, the medical field is moving towards personalized medicine or precision medicine. In precision medicine, instead of one standard drug, patients are prescribed medicines depending on their genes, environment, and disease. Probiotic therapy is one easy way to deliver precision medicine. For instance, gut microbe data along with other data such as diet can help in monitoring a patient’s blood sugar with greater precision.

Although probiotic therapy is beneficial, clinicians disagree on certain aspects. For instance, there is no consensus about the effectiveness of probiotic therapy in older adults or the effectiveness of probiotic therapy on C. difficile bacteria. Probiotic therapy is generally considered safe, but data related to its safety is still emerging.

Antibiotic-associated diarrhea can be a painful and frustrating side effect when fighting an infection. Probiotics offer a promising treatment for this condition. If you have recently been prescribed antibiotics, make sure you talk to your doctor about potentially starting probiotics.