Probiotics are live microorganisms (microscopic living things such as bacteria, protozoa, algae and fungi) that can provide various health benefits. You can find probiotics in different sources, such as dietary supplements and certain foods.

Research suggests that probiotics may help prevent antibiotic-associated diarrhea and reduce the risk of Clostridioides difficile (formerly Clostridium difficile) infection.

If you are taking an antibiotic for a bacterial infection, your doctor may recommend taking a probiotic to support gut health. However, some people may benefit more than others from taking probiotics.

Can probiotics reduce antibiotic side effects?

There are many types of antibiotics, each with specific side effects. Although antibiotics work on “bad” bacteria, many antibiotics, especially broad-spectrum antibiotics, also disrupt “good” bacteria.

Recent research suggests that the combination of probiotics and antibiotics has no effect on the general condition. intestinal microbiota balance and diversity. However, probiotics can still be considered in certain cases, such as to prevent antibiotic-associated diarrhea.

Diarrhea is a common side effect of antibiotics, which usually goes away when you finish taking them. However, some people develop a more serious type of antibiotic-associated diarrhea, called Clostridioides difficile infection (CDI). CDI is caused by bacteria that produces toxins and can cause symptoms ranging from mild diarrhea to severe inflammation of the colon.

The research revealed the following:

• A 2017 review of studies in outpatients (people not staying in a hospital or facility) found that taking probiotics with antibiotics reduced the risk of antibiotic-associated diarrhea by about half. However, the researchers noted that the quality of the studies was “moderate.”
• A review of studies investigating probiotics for the prevention of antibiotic-associated diarrhea in children found moderate-quality evidence that probiotics had a protective effect in preventing diarrhea, including types Lactobacillus rhamnosus Or Saccharomyces boulardii.
• Another review of studies found that probiotics may help reduce antibiotic-associated diarrhea in adults, but these benefits were not seen in people aged 65 and older.
• It is better to take a probiotic within the first two days of starting antibiotic treatment rather than starting later.

For CDI specifically, a 2017 review of studies found that probiotics may reduce the risk of CDI in adults and children who take antibiotics. Researchers have found that taking probiotics is generally safe except for people with weakened immune systems.

However, it is important to consider that a weakened immune system is a risk factor for CDI. Therefore, people with weakened immune systems should consult a healthcare professional before using probiotics to prevent CDI.

Can probiotics make antibiotics more effective?

Although it is rare, some research suggests that probiotics may improve the effectiveness of antibiotics in some cases.

For example, in people with Helicobacter pylori infection (a type of bacteria that can cause stomach infections and ulcers), taking a probiotic can strengthen the effect of the antibiotic, leading to better results and maintaining the balance of the intestinal flora.

In general, however, the goal of taking probiotics with antibiotics is to help prevent diarrhea and CDI rather than to improve their effectiveness.

Is taking probiotics with antibiotics safe for me?

The best way to know if taking probiotics with antibiotics is safe for you is to ask your doctor.

The American Gastroenterological Association (AGA) has published clinical guidelines for probiotics in digestive disorders. They recommend certain probiotic formulations only in certain situations, one of which is to prevent CDI in adults and children taking antibiotics.

Due to a lack of evidence, the AGA does not recommend that people take probiotics to treat certain conditions, such as:

Additionally, probiotics may not be suitable for someone with a weakened immune system or certain health conditions. Always consult a healthcare professional before taking a probiotic with an antibiotic or giving your child a probiotic with an antibiotic.

Who benefits the most?

Since taking probiotics with antibiotics may reduce the risk of CDI, those who might benefit most are people at higher risk of CDI, such as people who:

• You have recently taken an antibiotic, especially for a long time
• Take certain antibiotics like clindamycin, a cephalosporinor a quinolone antibiotic like ciprofloxacin or levofloxacin
• Are elderly people
• Have a weakened immune system or other illness
• You are staying in a hospital or long-term care facility
• You have certain health conditions (such as inflammatory bowel disease) or are taking certain medications (such as proton pump inhibitors)

Check with your healthcare professional before adding a probiotic to your antibiotic treatment.

What strain of probiotic should I take?

Adults and children taking antibiotics should consult a healthcare professional before starting a probiotic.

The AGA provides a conditional recommendation (meaning the recommendation may be suitable for most people but not everyone) based on “low-quality evidence” for the following probiotic strains:

• Saccharomyces boulardii
• Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R
• Lactobacillus acidophilus, Lactobacillus delbrueckii subspecies. bulgaricusAnd Bifidobacterium bifidum
• Lactobacillus acidophilus, Lactobacillus delbrueckii subspecies. bulgaricus, Bifidobacterium bifidum, And Salivary Streptococcus subspecies. thermophilus

You can also ask your healthcare professional or pharmacist for a recommendation.

When should I take the probiotic?

Typically, you take a probiotic for the duration of the antibiotic treatment. You can start the probiotic the same day you start the antibiotic. Experts recommend starting the probiotic within two days of the antibiotic.

Summary

Probiotics are live microorganisms that can support gut health. Some research suggests that taking probiotics with antibiotics may help prevent antibiotic-associated diarrhea and reduce the risk of Clostridioides difficile infection (CDI).

People at high risk for CDI, such as people who take long-term antibiotics and those with certain medical conditions, may benefit more from using probiotics. The American Gastroenterological Association recommends specific probiotic strains to prevent CDI, but it is important to consult a healthcare professional before starting to take probiotics.