- Antibiotics treat bacterial infections but can disrupt gut microbiome balance.
- Probiotics may restore healthy gut bacteria and counteract antibiotics' negative effects.
- Probiotics' effectiveness varies; their exact mechanism in the body is not fully understood.
- Probiotics may help prevent antibiotic-associated diarrhoea and other gastrointestinal issues.
- Timing is key: take probiotics at least two hours apart from antibiotics.
- Research on probiotics' efficacy is ongoing; consensus among health bodies is not yet reached.
- Several health bodies recommend specific probiotic strains for use with antibiotics.
- Probiotic-rich foods include yoghurt, kefir, sauerkraut, tempeh, miso, pickles, kimchi, certain cheeses, and kombucha.
- Check for "live cultures" or "active cultures" on food labels to ensure probiotic effectiveness.
- Consult healthcare professionals before combining probiotics with antibiotics or other medications.
Is it a good idea to take probiotics along with antibiotics?
We know that antibiotics are powerful superheroes in the fight against infection-causing villainous bacteria. Probiotics, on the other hand, are like the veritable sidekicks that protect our stomachs in the meantime. In this article, we closely examine what science says about combining probiotics and antibiotics, and if it's a wise choice.
Antibiotics vs. Probiotics | What's the Difference?
To understand the effects of taking probiotics and antibiotics together, it's important to know how they both work in the body.
Antibiotics are drugs prescribed by physicians to treat certain infections caused by bacteria. They work to either kill the bacteria completely or prevent it from growing and multiplying. Sometimes you may even be prescribed antibiotics to prevent an infection in special circumstances, such as before surgery.
They're not prescribed for routine infections because the body can typically fight against those on its own. Over time, the misuse of these medications can lead to antibiotic resistance, making it harder to treat bacterial infections effectively.
They're also not prescribed for viral infections like the flu, coughs, the common cold, and sore throats because they're ineffective against viruses.
The idea of voluntarily consuming live micro-organisms might seem odd. However, some microorganisms such as probiotics may provide health benefits for human beings. Adding probiotics to your diet may:
- Maintain or restore a healthy community of micro-organisms in your body, typically after illness.
- Produce substances that may have a beneficial effect on the body.
- Positively impacts your immune system, so it's healthier and works better.
The exact mechanism by which probiotics work is not known at this time but consuming probiotics has been shown to potentially help with the:
- Reduction of antibiotic-associated diarrhoea (including diarrhoea caused by Clostridium difficile)
- Prevention of necrotizing enterocolitis (a condition mostly seen in infants where the tissue lining the intestine gets inflamed, dies, or sloughs off)
- Protection from sepsis in premature infants (a serious medical condition where the infant has a life-threatening reaction to an infection)
- Treatment of infant colic (when an infant cries for a long time displaying signs of significant distress despite otherwise being well-fed and healthy)
- Treatment of periodontal disease
- Induction and maintenance of remission in ulcerative colitis (a type of inflammatory bowel disease)
Taking Probiotics with Antibiotics: What You Need to Know
There may be times when you'll be asked to take antibiotics and probiotics together. While antibiotics have proven to be an effective treatment, they can disrupt the balance of good bacteria that's naturally present in your gut. They can affect how much of healthy microbes you have and how diverse your gut microbiota is. This can cause antibiotic-associated diarrhoea and other uncomfortable gastrointestinal symptoms.
This is chiefly because antibiotics do not differentiate between good and bad bacteria. So, a probiotic is usually prescribed to help restore the delicate gut microbiome. It's also recommended to space out the intake of an antibiotic and a probiotic so they don't cancel each other out, so to speak. Ideally, keep a two-hour window between the two, however, we recommend you follow your physician's recommendations.
If in doubt, we recommend reading our post about the signs that indicate probiotics are working.
What the Research Says
Antibiotic-associated diarrhoea, or AAD for short, can affect as much as a third of the number of people who consume antibiotics. It can start from the beginning of the antibiotic therapy and last for up to two months after the end of the treatment. This is why healthcare professionals often consider preventive measures, such as recommending probiotics, to potentially combat gastrointestinal abnormalities like AAD during antibiotic treatment.
While previous research shows the potential efficacy of probiotics in preventing or treating AAD, most of the research involves the inpatient setting. This means the parameters vary from outpatient settings (i.e. the strength of the antibiotic treatment, how the drug is administered, and the potential pathogens).
At the moment, there is no consensus on whether probiotics can be conclusively used for AAD. However, several governing health bodies have recommended the use of certain strains of probiotics based on available literature with caveats.
For example, the American Gastroenterological Association (AGA) suggested that certain strains or combination strains such as S. boulardii, L. acidophilus CL1285 and L. casei, may be applied for adults and children who are being treated with antibiotics. They, however, recommended against the use of probiotics for people with serious illnesses or people who are concerned about the costs of probiotics.
The European Society of Clinical Microbiology and Infection (ESCMID) guidelines do not recommend probiotics for C. difficile-associated Diarrhoea. This form of diarrhoea is most commonly seen in elderly patients and hospitalized patients receiving broad-spectrum antibiotics (works against a wide range of disease-causing bacteria). All bodies agree on the need for more research.
Are There Probiotic Foods I Can Take?
Otherwise healthy adults have a variety of probiotic-rich foods to choose from to maintain gut health. These include:
- Yoghurt: A common source of probiotics.
- Kefir: A fermented milk drink.
- Sauerkraut: Fermented cabbage, known for its probiotic content.
- Tempeh: A type of soybean product.
- Miso: A fermented Japanese soybean seasoning.
- Pickles: These can be a good source of probiotics if fermented in brine.
- Kimchi: A spicy Korean side dish made from fermented vegetables.
- Homemade Buttermilk: Particularly the traditional varieties.
- Certain Types of Cheeses: Look for those that are labelled as containing live cultures.
- Kombucha: A fermented black or green tea.
To ensure you're getting a genuinely probiotic-rich food that has live microorganisms, look for the words "live cultures," or "active cultures," on your food labelling. Remember, probiotics won't help if the micro-organisms are dead!
In addition to the probiotic-rich foods mentioned, you can also consider taking probiotic supplements. One recommended brand is the Seed DS-01 Probiotics.
But while you're being treated for an illness your physician may make a recommendation for a specific type of probiotic to prevent gastrointestinal upset.
Frequently Asked Questions (FAQs)
Q1. When should I take probiotics when taking antibiotics?
It is best to take probiotics the same day you start your course of antibiotics with a minimum gap of at least two hours between the two. The longer you wait, the less effective the antibiotics. Antibiotics are unable to distinguish between good and bad gut bacteria, and probiotics will help to restore gut microbial flora.
Q2. What medications should not be taken with probiotics?
Generally, probiotics are considered safe for most healthy adults. However, probiotics may interact with certain medications including some antibiotics, antifungals (for example, clotrimazole, ketoconazole, griseofulvin, nystatin), immunosuppressants or steroids (for example, prednisone). If you are currently taking medication, consult your physician to understand whether you can take probiotics. Probiotic strains have to be matched to the specific illness.
Q3. How long should you wait to eat after taking a probiotic?
The closer to neutral the pH value of the stomach is the more likely the probiotics will survive. Research suggests that probiotics are most likely to survive when taken before or at the start of a meal, rather than 30 minutes after. Also, a quick tip - consume your probiotics with foods containing healthy fats like olive oil, coconut oil, flax oil, seeds, nuts, and avocado, to maximise the survival and efficacy of probiotics.
Not all heroes like antibiotics wear capes! Antibiotics, essential in combating bacterial infections, may inadvertently disrupt our delicately balanced gut health. In this context, probiotics have been studied for their potential to aid in maintaining gut health, especially when antibiotics are used.
Studies show that, in some cases, taking probiotic supplements alongside antibiotic use can be beneficial, helping to mitigate some of the gut-related side effects of antibiotics.
However, individual responses vary so consulting healthcare professionals to understand the best course of action for your specific health needs is always recommended.