The importance of gut health and its impact on overall well-being has become increasingly evident. One area where this is particularly crucial is during antibiotic treatment. While antibiotics effectively combat bacterial infections, they can also disrupt the delicate balance of beneficial bacteria in our gut, leading to potentially undesirable effects.
To address this issue, probiotics have gained significant attention as a complementary solution. Here, we review the offerings of five leading probiotic brands in 2023 — Culturelle, Ritual, Pure Essence Labs, YourBiology, and Oweli—to help you make informed choices for supporting your gut health during antibiotic therapy.
Best probiotics to take with antibiotics: a shortlist
- Culturelle – overall best probiotic when taking antibiotics
- Ritual – best probiotic for intestinal barrier health
- Pure Essence Labs – best probiotic after antibiotics
- YourBiology – best probiotic for women's gut health
- Oweli – best probiotic for overall gut health
How to choose the best probiotics to take with antibiotics
Choosing the best probiotics to take with antibiotics requires careful consideration and consultation with your healthcare provider. Below are some key factors to keep in mind when choosing the best probiotics to take with antibiotics.
|Strains of bacteria||Contains the right strains to help against antibiotics-associated negative effects|
|CFU count||Adequate CFU count of live bacteria|
|Diversity||Multi-strain or broad-spectrum formulations have more holistic beneficial effects|
|Formulation||Formulated to resist stomach acid and contains prebiotics|
|Packaging||The probiotic products should be sealed and packaged very carefully such that no external factors such as moisture or air can enter the probiotics|
- Strains of bacteria. Choose a probiotic that contains strains that have been shown to be effective in preventing and treating antibiotic-associated undesirable effects, such as diarrhea. The most popular probiotics are the Lactobacilli and Bifidobacteria strains.
- CFU count. The CFU count is the number of live bacteria in a probiotic supplement. A higher CFU count means more live bacteria in the supplement, which can benefit gut health.
- Diversity. A probiotic supplement with multiple strains can offer a more comprehensive approach to supporting gut health.
- Formulation. The best probiotic products are designed to allow beneficial bacteria to be optimally delivered to the gut. With protection from stomach acidity and supplementation of prebiotic fibers, a formulation has the upper hand in ensuring maximum potency.
- Packaging. Packaging should provide protection through certain methods that seal the probiotics to prevent moisture, light, and air from compromising the viability of the probiotics. This guarantees the number of live bacteria at maximum potency.
In addition to these criteria, you may also want to consider the following factors when choosing probiotics to take with antibiotics: your individual needs, your budget, and the reviews.
Best probiotics to take with antibiotics in 2023 an overview
The significance of probiotics in supporting gut health during antibiotic treatment remains a top priority for individuals and healthcare providers alike. As antibiotics effectively combat infections, they can also disrupt the natural balance of beneficial bacteria in the gut, leading to potential side effects. Selecting the best probiotics to take alongside antibiotics can play a crucial role in minimizing these disturbances and promoting overall well-being.
Based on the above-mentioned criteria, here are five best probiotics to take with antibiotics:
Culturelle Ultimate Balance for Antibiotics
Culturelle Ultimate Balance for Antibiotics is a probiotic supplement designed to rebuild the bacterial balance lost due to antibiotic use. The product includes one strain, which was reported to be the most clinically-studied strain as of January 2019.
- Lactobacillus rhamnosus (LGG).
In addition to the probiotic with 20 billion CFU, the formulation includes inulin (Chicory root extract) which serves as prebiotic fiber and can serve as a feed source for good bacteria. According to the company, they guarantee the number of live bacteria as they measured them at the expiration date instead of just during the manufacturing date, ensuring that sufficient bacteria are alive and can provide the expected health effects.
It is intended for use with antibiotics, both during and after, to bring the digestive system back in balance in terms of the gut microbiome. It may potentially reduce diarrhea, gas, and bloating, as well as support healthy digestion, immune health, and overall health.
Ritual Gut Health Synbiotic+
Ritual Gut Health Synbiotic+ is a 3-in-1 supplement that includes clinically tested prebiotics, probiotics, and postbiotics ingredients to support a balanced gut microbiome.
- Prebiotic. Synbiotic+ product contains Prefor Pro, a commercial cocktail of bacteriophages, which has prebiotic effects wherein it supports the growth of beneficial bacteria and is linked to the elimination of the pathogenic gut bacteria, E. coli.
- Probiotic. Synbiotic+ product contains a probiotic blend of two strains: Lactobacillus rhamnosus (LGG) and Bifidobacterium animalis ssp. lactis (BB-12), which are noted as two of the world's most clinically studied probiotic strains.
- Postbiotic. Synbiotic+ product contains Tributyrin (CoreBiome) which is a short chain fatty acid ingredient related to butyrate which is commonly produced by good bacteria and is used to fuel gut lining cells that maintain the function of the intestinal barrier.
Synbiotic+ offers 11 billion CFU's per serving. It has its own in vitro study conducted that showed the advantageous effects such as an increase in butyrate production, microbial diversity, and growth of beneficial bacteria. It may provide the potential health benefits of probiotic supplementation such as promoting gut barrier health, supporting immune function, and providing digestive support through the potential relief from mild and occasional bloating, gas, and diarrhea which may be helpful during antibiotic therapy.
Pure Essence Labs' PureBiotics Maxima
Pure Essence Labs' PureBiotics Maxima is a broad-spectrum probiotic blend intended for people with severe probiotic depletion. In addition, this product may provide the regular health benefits expected from the clinically tested probiotic ingredients to recover a healthy microbiome as well as support immune and respiratory health.
PureBiotics Maxima contains 15 strains of bacteria from Lactobacillus and Bifidobacterium species with 100 billion CFU per serving:
Generally, Lactobacilli normally live in the digestive, urinary, and genital systems, and Bifidobacteria normally live in the intestines. With this diverse formulation, PureBiotics Maxima may potentially restore the gut microbiome and help combat the signs of probiotic depletion, such as diarrhea, constipation, impaired immunity, overgrowth of yeasts and pathogenic bacteria, skin problems and allergies, respiratory infections, and vaginal and urinary tract infections.
YourBiology Gut+ is a probiotic + prebiotic formula with 40 billion CFU's of four live strains of good bacteria.
- Lactobacillus acidophilus
- Bifidobacterium lactis
- Lactobacillus plantarum
- Lactobacillus paracasei
In addition to this probiotic blend, it is formulated with MAKtrek bi-pass technology, a protective complex against stomach acid, and a prebiotic fiber (fructooligosaccharide) that can support the growth of good bacteria. YourBiology company claims up to 250 times the survival rate of probiotics than standard probiotic products in the market, even without refrigeration.
YourBiology Gut+ supplement ingredients are backed by scientific studies that report the potential benefits of probiotics in reducing stress, improving digestion, enhancing energy and focus, supporting women's gut health, strengthening immunity, improving skin health, and supporting weight management. Although not stated on the company website. Gut+ may also be used to help restore the microbiome balance during antibiotic treatment.
Oweli Probiotic formula is another probiotics + prebiotics supplement formula with 40 billion CFU's containing 4 strains of live bacterial cultures. Apparently, Oweli's ingredients' formula is similar to YourBiology Gut+.
- Lactobacillus acidophilus
- Bifidobacterium lactis
- Lactobacillus plantarum
- Lactobacillus paracasei
In addition to these four strains, Oweli probiotic product is also protected by MakTrek Bi-Pass Technology against stomach acids and also contains the prebiotic fructooligosaccharide (but is offered at a cheaper price than YourBiology Gut+).
With this formula, Oweli probiotics can also provide relief from antibiotic-associated negative effects such as diarrhea, gas, or bloating, while countering the depletion of the gut microbiome. According to the product website, it may provide probiotics-associated health benefits to support a healthy gut microbiome, digestive health, metabolism, weight management, immune responses, skin health, as well as mood and well-being.
Comparing the best probiotics to take with antibiotics
When choosing the best probiotics to take with antibiotics, it is essential to consider several factors to make an informed decision, depending on your specific needs and personal circumstances.
Here is a summary table to help you choose the right probiotic supplement based on price, serving size, strains, CFU count, composition, and whether stomach acid protection.
|Brand||Price/bottle||Serving size||Strains||CFU count||Composition||Stomach acid protection||Review|
|Culturelle||$21.99 (20 capsules per bottle)||1 capsule per day||1 strain||20 billion||Probiotics added with prebiotic fibers from inulin.||No, (but L. rhamnosus is robust and can survive in acidic environment)||Culturelle review|
|Ritual||$54 (30 capsules per bottle)||1 capsule per day||2 strains||11 billion||Probiotics added with prebiotic bacteriophages and postbiotic tributyrin.||Yes, (delayed-release technology)||Ritual review|
|Pure Essence Labs||$74.60 (30 capsules per bottle)||1 capsule per day||15 strains||100 billion||Only a probiotic blend.||Yes, (delayed-release technology)||Pure Essence Labs review|
|YourBiology||$79.99 (60 capsules per bottle)||2 capsules per day||4 strains||40 billion||Probiotics added with prebiotic fibers from marine polysaccharide complex.||Yes, (MakTrek Bi-Pass Technology)||YourBiology review|
|Oweli||$29.99 (60 capsules per bottle)||2 capsules per day||4 strains||40 billion||Probiotics added with prebiotic fibers from marine polysaccharide complex.||Yes, (MakTrek Bi-Pass Technology)||-|
How we compiled our list of the best probiotic to take with antibiotics in 2023
We compiled our list of the best probiotics to take with antibiotics in 2023 based on the following criteria.
- Composition. The product ingredients are formulated to optimally encourage the growth and survival of the live beneficial bacteria. Probiotic products with prebiotics included in formation are more desirable than probiotics alone.
- Probiotics' survival. We considered probiotic brands that were designed to stand the harsh stomach acids before reaching the colon/intestines, where they are optimally functional. Some strains are naturally robust against stomach acid, while some should be protected by special technologies, or formulated in a delayed-release method to ensure their viability upon reaching the colon.
- Provider. A company or brand that is reputable and is already established in the market through the years supports its capacity to produce quality products with expertise. Brands that undergo third-party testing show their confidence in their quality.
- Customer reviews. We assess whether the users are satisfied with the health effects of the brand/product through public customer reviews and testimonials.
What are antibiotics?
Antibiotics are a class of medications used to treat bacterial infections.
They work by either killing bacteria (bactericidal) or inhibiting their growth and reproduction (bacteriostatic). Antibiotics are not effective against viral infections like the common cold or the flu, as viruses have different structures and mechanisms than bacteria.
Possible side effects of antibiotics
While highly effective in treating bacterial infections, antibiotics, like all medications, can have side effects that vary depending on the type of antibiotic, the individual's health, and other factors.
Here are some common side effects associated with antibiotics:
- Digestive issues. Antibiotics can disrupt the natural balance of bacteria in the gut, leading to gastrointestinal symptoms. Common digestive side effects include nausea, vomiting, diarrhea, and abdominal pain. These symptoms can range from mild to severe.
- Yeast infections. Antibiotics may lead to an overgrowth of yeast (Candida) in certain individuals, causing vaginal yeast infections or oral thrush (a fungal infection in the mouth and throat).
- Allergic reactions. Some people may experience allergic reactions to certain antibiotics. Symptoms of an allergic reaction can include skin rashes, itching, hives, swelling of the face or throat, and difficulty breathing. Severe allergic reactions, such as anaphylaxis, are rare but can be life-threatening and require immediate medical attention.
- Photosensitivity. Certain antibiotics, particularly tetracyclines, and fluoroquinolones, can make the skin more sensitive to sunlight, leading to an increased risk of sunburn or skin rashes when exposed to the sun.
- Organ toxicity. In some cases, specific antibiotics may have the potential to cause toxicity to organs such as the liver or kidneys. Regular monitoring of liver and kidney function may be necessary during antibiotic treatment, especially with long-term use or in patients with pre-existing organ conditions.
Taking antibiotics responsibly and as prescribed by a healthcare professional can help minimize the risk of side effects and reduce the development of antibiotic resistance.
Benefits of taking probiotics with antibiotics
Taking probiotics with antibiotics can offer several potential benefits, especially in helping to counteract some of the adverse effects of antibiotic treatment on the digestive system.
The main benefits of taking probiotics alongside antibiotics:
Restoring gut microbiota balance
Antibiotics not only target harmful bacteria causing infections, but can also affect the beneficial bacteria in the gut. Probiotics are live microorganisms that, when consumed in adequate amounts, can help restore the balance of the gut microbiota by replenishing the beneficial bacteria that may be depleted during antibiotic treatment.
Antibiotic-associated diarrhea is a common side effect that occurs due to the disruption of the gut microbiota. Probiotics, particularly strains like Lactobacillus rhamnosus and Bifidobacterium animals ssp. animalis, have been shown to reduce the risk of antibiotic-associated diarrhea by maintaining a healthier gut environment.
Reducing the risk of yeast infections
Antibiotics can lead to an overgrowth of yeast in the body, potentially causing vaginal yeast infections or oral thrush. Probiotics can help by inhibiting the growth of harmful yeast species and maintaining a balanced microbial environment.
Enhancing immune function
A healthy gut microbiota is closely linked to a well-functioning immune system. By promoting a balanced gut microbiome, probiotics may contribute to better immune function and overall health, potentially supporting the body's ability to fight infections.
Minimizing antibiotic resistance
Although not a direct benefit, taking probiotics responsibly alongside antibiotics may indirectly help reduce the development of antibiotic resistance. When probiotics restore the gut's microbial balance, it may decrease the overgrowth of antibiotic-resistant bacteria.
Overall, it is important to note that not all probiotics are the same, and the effectiveness of a probiotic supplement may depend on the specific strains and the dose used. When considering probiotics while taking antibiotics, it is best to consult with a healthcare professional or a registered dietitian.
Are there any risks of not taking probiotics with antibiotics
Not taking probiotics with antibiotics does not pose any direct health risks.
Antibiotics are prescribed to treat bacterial infections, and their primary function is to eliminate harmful bacteria causing an infection. While antibiotics can have side effects, the decision to take probiotics alongside them is not mandatory.
Without probiotics during antibiotic treatment, it may lead to potential digestive issues and an imbalanced gut microbiota – it can disrupt the natural balance of beneficial bacteria, increasing the risk of antibiotic-associated diarrhea and yeast infections. Probiotics can help restore the gut's microbial balance, supporting digestion and overall well-being. While not required, considering probiotics during antibiotic treatment can be beneficial in minimizing these risks and maintaining gut health.
Best time to take probiotics
Ultimately, there is no definitive consensus on the best timing for taking probiotics with antibiotics. The best time to take probiotics while on antibiotics depends on your individual circumstances and preferences. Some individuals may experience better results with one method over the other.
Together with antibiotics
Some research suggests that taking probiotics concurrently with antibiotics can be beneficial. By doing so, you are introducing beneficial bacteria to your gut while the antibiotics are active, which may help maintain a healthier gut microbiota. This approach aims to maintain a healthier gut microbiota during antibiotic treatment, potentially reducing the risk of antibiotic-associated digestive issues.
Findings indicate that when probiotics are taken alongside your antibiotics, it may reduce the antibiotic-associated damage to your gut microbiome. Further studies support that taking probiotics together with antibiotics can offer protection against some negative impacts of antibiotic use on the gut microbiome.
This method can be beneficial for those looking to support their gut health while undergoing antibiotic treatment.
After taking antibiotics
Another approach is to start taking probiotics after antibiotics. Some would recommend taking probiotics at least two hours after antibiotic intake, while others also suggest taking probiotics after you have completed your course of antibiotics.
Taking the probiotics a few hours after antibiotic intake reduces the risk that the probiotics will be killed by the antibiotic drugs, while replenishing your microbiome afterward and providing its potential beneficial effects. On the other hand, if you take the probiotics after the course of your antibiotic treatment, it allows you to avoid any potential interactions between the antibiotics and probiotics (if any) and gives your gut microbiota a chance to recover naturally when the antibiotic treatment is over.
This may be preferred for individuals concerned about possible interference or those who want to allow their gut to return to its pre-antibiotic state before introducing new beneficial bacteria. However, this method does not provide immediate support during antibiotic treatment.
Other ways to replenish your good bacteria
Incorporating a diverse range of gut-beneficial foods into your diet can support a balanced and thriving gut microbiota, which plays a crucial role in overall digestive health and overall well-being.
Here are four additional ways to replenish and promote the growth of good bacteria in your gut:
Prebiotics are non-digestible fibers that serve as food for beneficial bacteria in the gut. Including foods rich in prebiotics like different varieties of vegetables can help nourish the existing good bacteria. Foods such as onions, garlic, leeks, asparagus, bananas, and oats are good sources of prebiotic fibers that can feed your good bacteria and promote their balanced growth and reproduction as well as their beneficial activities.
Incorporating fermented foods introduces live probiotic cultures into your gut. The fermentation process increases the number of beneficial bacteria, contributing to improved gut health and digestion. This is another way of replenishing your gut microbiome to counter the negative effects of antibiotic treatment. Kimchi, kefir, sauerkraut, miso, natto, tempeh, and kombucha are excellent sources of live good bacteria.
Probiotic supplements are available in various forms, such as capsules, tablets, and powders formulated in amounts sufficient to help your gut microbiome. They provide concentrated doses of specific probiotic strains. When choosing a probiotic supplement, look for products with strains that have been studied for their potential health benefits, such as Lactobacillus acidophilus, Lactobacillus rhamnosus GG, or Bifidobacterium lactis.
Probiotic-fortified foods and beverages like certain yogurt drinks, fermented milk drinks, and cereal bars provide an additional way to consume probiotics. Incorporating these products into your diet can offer an easy and enjoyable method of replenishing beneficial gut bacteria. Fermented milk drinks and yogurts also have live cultures of good bacteria that are beneficial for gut issues.
Our conclusion of the best probiotics to take with antibiotics
Overall, we deem that Culturelle Ultimate Balance for Antibiotics is potentially the best probiotic to take during antibiotics treatment. Lactobacillus rhamnosus GG strain is very well-documented to reduce the frequency and duration of diarrhea, including antibiotic-associated diarrhea, and other gut/digestive discomfort.
Although the other probiotics contain Lactobacillus rhamnosus, based on 20 billion CFU count per serving size, Culturelle may potentially deliver more beneficial Lactobacillus rhamnosus to the gut during antibiotic treatment to counter the antibiotic-associated negative effects, restore the balance of the microbiome, and support healthy gut function. Meanwhile, although Culturelle Ultimate Balance for Antibiotics product was not formulated with protection against stomach acid, it is not really necessary since Lactobacillus rhamnosus GG strain is known to be naturally robust to survive acid conditions.
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Which probiotic should I take with antibiotics?
When taking probiotics with antibiotics, choose a product containing Lactobacillus or Bifidobacterium strains, as these are commonly studied for their potential benefits during antibiotic use. Look for supplements with diverse strains and high colony-forming units (CFUs) counts. It is essential to consult your healthcare provider to determine the most suitable probiotic based on your health condition and the specific antibiotics you are taking.
Is it OK to take probiotics and antibiotics at the same time?
It is generally safe to take probiotics and antibiotics together, but it is best to stagger their intake by 2-4 hours. This helps avoid any potential interference with antibiotic effectiveness or killing the probiotics. Probiotics can help maintain gut health during antibiotic treatment, but specific strains and dosages should be discussed with a healthcare professional to ensure effective treatment.
What to avoid while on antibiotics?
While on antibiotics, it is recommended to avoid alcohol consumption as it can reduce antibiotic effectiveness and cause adverse effects. Additionally, avoid certain foods that may interfere with drug absorption or irritate the digestive system, such as highly acidic foods. For more personalized advice, follow your healthcare provider's instructions closely and take antibiotics as prescribed.
Is it OK to eat yogurt while taking antibiotics?
Yes, it is generally safe to eat yogurt while taking antibiotics. Yogurt contains probiotics, which can help maintain a healthy gut microbiome. However, it is best to consume yogurt a few hours after taking antibiotics to ensure that the antibiotics are not affected. Always consult with your healthcare provider for personalized advice on diet and medication interactions.