What Probiotics Should You Take With Antibiotics?

According to a meta-analysis of 34 studies, probiotic use can reduce instances of antibiotic-associated diarrhea (AAD) by 52%. Taking certain probiotics with antibiotics is a researched strategy to help mitigate the disruption to your gut microbiome, minimize side effects, and support a quicker return to a healthy bacterial balance.

Quick Summary

Specific probiotic strains, such as Saccharomyces boulardii and Lactobacillus rhamnosus GG, are recommended to counteract the gut flora disruption caused by antibiotics. Timing your probiotic dose at least two hours away from your antibiotic is crucial for viability, and continuing supplementation after the course is complete aids in microbiome restoration.

Key Points

• Choose Specific Strains: Not all probiotics are effective with antibiotics. Look for well-researched strains like Saccharomyces boulardii (a yeast) or Lactobacillus rhamnosus GG.

• Respect the Timing: Take bacterial probiotics at least two hours away from your antibiotic dose. Saccharomyces boulardii is naturally resistant and can be taken at the same time.

• Start Early, Finish Late: Begin taking probiotics the same day you start antibiotics and continue for at least one to two weeks after completing the course to aid gut recovery.

• Prioritize High Potency: Opt for high-quality supplements with a high CFU count (5-40 billion per day is a recommended range) for effective support.

• Support with Prebiotics: After your antibiotic course, incorporate prebiotic-rich foods to feed the new beneficial bacteria and restore your microbiome's diversity.

• Consult Your Doctor: Always talk to your healthcare provider before starting a new supplement, especially if you are immunocompromised or have existing health conditions.

The Double-Edged Sword of Antibiotics

Antibiotics are essential medications that combat bacterial infections but also kill beneficial bacteria in the gut, leading to dysbiosis. This imbalance can cause gastrointestinal side effects like diarrhea and bloating, and in some cases, serious infections like Clostridioides difficile (C. diff). The goal of taking probiotics with antibiotics is to restore the gut microbiome's balance.

Why Taking Probiotics with Antibiotics is Important

Introducing live microorganisms through probiotics can help repopulate the gut with beneficial bacteria. Key benefits include:

• Reduced Antibiotic-Associated Diarrhea (AAD): Specific probiotic strains can significantly lower the risk of diarrhea during antibiotic use.
• Prevention of C. difficile Infection: Probiotics may offer protection against C. diff overgrowth, especially for those at higher risk.
• Microbiome Support: Probiotics help maintain a healthier microbial balance during and after antibiotic therapy.
• Enhanced Immune Function: A balanced gut microbiome, supported by probiotics, contributes to a robust immune response.

The Top Probiotic Strains to Take with Antibiotics

Selecting the right probiotic strain is crucial, as not all are effective alongside antibiotics. Research supports strains such as:

1. Saccharomyces boulardii

This beneficial yeast is naturally resistant to antibiotics, allowing it to be taken concurrently. It is effective at preventing AAD and has specific anti-C. diff properties. A common strain is Saccharomyces boulardii CNCM I-745.

2. Lactobacillus rhamnosus GG (LGG)

One of the most researched bacterial strains for antibiotic support, LGG is known for reducing the incidence and duration of AAD in both children and adults. It should be taken at least two hours apart from antibiotic doses.

3. Bifidobacterium lactis Bl-04

This strain helps enhance the recovery of gut bacteria populations after antibiotic use. Multi-strain probiotics containing B. lactis Bl-04 have shown promise in reducing gut bacterial disturbance and maintaining Bifidobacteria levels during and after therapy. Like LGG, take this strain a few hours apart from your antibiotic.

Comparison of Key Probiotics with Antibiotics

Feature	Saccharomyces boulardii	Lactobacillus rhamnosus GG (LGG)	Bifidobacterium lactis Bl-04
Microbe Type	Yeast	Bacteria	Bacteria
Antibiotic Resistance	Naturally Resistant	Sensitive (needs separation)	Sensitive (needs separation)
Optimal Timing	Can be taken with antibiotics	2+ hours away from antibiotics	2+ hours away from antibiotics
Primary Benefit	Preventing AAD and C. diff	Reducing AAD incidence/duration	Restoring Bifidobacteria levels
Typical Dosage	5-10 billion CFUs/day	10-20 billion CFUs/day	Often in multi-strain blend

How to Take Probiotics with Antibiotics

For most bacterial probiotics, timing is important. Aim for at least a two-hour gap between your antibiotic and probiotic doses.

1. Take your antibiotic as prescribed.
2. Wait 2 or more hours.
3. Take your probiotic supplement.
4. Take the probiotic daily throughout the antibiotic course.
5. Continue taking the probiotic for at least one to two weeks after finishing the antibiotic to help restore the gut microbiome.

Natural Approaches and Supportive Foods

Support your gut during and after antibiotic treatment with dietary choices:

• Fermented Foods (Post-Antibiotics): After finishing antibiotics, foods like yogurt, kefir, and sauerkraut can provide diverse bacteria.
• Prebiotic-Rich Foods (Post-Antibiotics): These fibers feed beneficial gut bacteria. Include foods like onions, garlic, bananas, and oats after your antibiotic course.
• Hydration and Rest: Essential for overall recovery and easing digestive discomfort.

The Importance of Consultation

Probiotics are generally safe but may not be suitable for those with severely compromised immune systems or critical illnesses. Always consult your healthcare provider before starting a probiotic, especially for children or those with chronic conditions. They can advise on suitable strains and dosages. For more information on gut health, you can consult resources like the {Link: American Gastroenterological Association https://www.gastro.org/}.

Conclusion

Taking specific probiotic strains with antibiotics is a researched method to protect gut health and reduce side effects like diarrhea. Saccharomyces boulardii and Lactobacillus rhamnosus GG are well-supported strains. Proper timing for bacterial probiotics and continued supplementation after the antibiotic course are key for supporting gut microbial balance. By choosing the right supplements, maintaining a supportive diet, and consulting your doctor, you can navigate antibiotic treatment effectively and support long-term gut health.

Frequently Asked Questions

Can I take any probiotic with my antibiotics?

No, it is crucial to choose clinically validated strains like Saccharomyces boulardii or Lactobacillus rhamnosus GG.

How long after finishing antibiotics should I keep taking probiotics?

It is recommended to continue taking probiotics for at least one to two weeks after you finish your antibiotic course to help restore a healthy balance.

Will antibiotics just kill the probiotics I take?

While many bacterial probiotics can be affected, certain strains like Saccharomyces boulardii (a yeast) are naturally resistant and can be taken concurrently. For bacterial strains, spacing your doses by at least two hours minimizes the chance of the antibiotic killing the probiotic.

Is it better to take a multi-strain or single-strain probiotic with antibiotics?

Multi-strain blends with clinically researched strains are often used effectively, and some research also highlights strong benefits from single, well-studied strains like Saccharomyces boulardii.

What is the ideal timing for taking probiotics with antibiotics?

For bacterial probiotics, take them at least two hours before or after your antibiotic dose. If you are taking the yeast-based Saccharomyces boulardii, timing is less of a concern as it is antibiotic-resistant.

Can I get enough probiotics from food instead of supplements?

Fermented foods are excellent for general gut health but typically don't provide the high concentration or specific, clinically studied strains needed to effectively counteract the effects of antibiotics.

Are probiotics safe for everyone when taking antibiotics?

Probiotics are generally safe, but individuals with compromised immune systems or critical illnesses should consult their healthcare provider before use.