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What Probiotics to Take With Antibiotics: The Ultimate Guide (2023)

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What Probiotics to Take With Antibiotics: The Ultimate Guide (2023)

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Probiotics with Antibiotics: Our guide zeroes in on a critical concern: How to maintain gut health while on antibiotics. If you're a healthcare provider or patient navigating antibiotic treatment, this article is your roadmap. We examine which probiotics are most effective in tandem with antibiotics, backed by current research.

What Probiotics To Take With Antibiotics

When taking antibiotics, it is important to consider probiotics that can help maintain a healthy balance of gut bacteria and prevent antibiotic-associated side effects such as diarrhea. Some probiotics that can be taken with antibiotics include:

  1. Medilac-DS: This probiotic contains a combination of Bacillus subtilis and Enterococcus faecium strains. In a clinical trial, it was administered three times a day alongside antibiotics for 14 ± 4 days, showing positive results in improving the clinical course of pneumonia in young people without comorbidities[2].
  2. Lactobacillus and Bifidobacterium strains**: These strains are commonly found in many probiotic supplements and have been shown to be effective in preventing antibiotic-associated diarrhea[3].
It is important to note that the effectiveness of probiotics can vary depending on the microbial species, and it is recommended to consult with a healthcare professional before starting any probiotic regimen alongside antibiotics. Additionally, the rates of probiotic co-prescription with antibiotics vary across countries, with some physicians being more likely to recommend probiotics to their patients than others.

Understanding Probiotics and Antibiotics

Probiotics and antibiotics are two distinct entities that play crucial roles in maintaining and improving human health. To fully comprehend the benefits and implications of taking probiotics with antibiotics, it is essential to understand the definitions and mechanisms behind these two components.

Definitions of Probiotics and Antibiotics

Probiotics refer to live microorganisms that, when administered in adequate amounts, confer health benefits to the host. Commonly known strains of probiotics include Lactobacillus and Bifidobacterium species, as well as Saccharomyces boulardii, a yeast. These microorganisms can be found naturally in certain foods and are also available as supplements.

On the other hand, antibiotics are medications specifically designed to eliminate or inhibit the growth of bacteria. They are instrumental in treating bacterial infections, but their use can also lead to unintended consequences, including disturbances to the delicate balance of gut flora.

How Probiotics and Antibiotics Work

Probiotics exert their beneficial effects through various mechanisms. They can modulate the immune system, enhance gut barrier function, produce antimicrobial substances, and compete with harmful bacteria for resources. By doing so, probiotics help maintain a healthy microbial balance and promote overall well-being.

In contrast, antibiotics work by targeting and killing specific bacteria or inhibiting their growth. They can be broad-spectrum, affecting a wide range of bacteria, or narrow-spectrum, targeting specific types of bacteria. While antibiotics are essential for tackling bacterial infections, their usage can inadvertently disrupt the equilibrium of gut flora.

The Relationship between Probiotics and Antibiotics

The relationship between probiotics and antibiotics is a complex and multifaceted one. Although antibiotics can have negative impacts on gut flora, taking probiotics concurrently with antibiotics can mitigate some of these undesirable effects and offer additional benefits.

The Impact of Antibiotics on Gut Flora

To understand why taking probiotics with antibiotics is advantageous, it is important to delve into the function of gut flora and how antibiotics can disrupt this delicate ecosystem.

The Function of Gut Flora

Gut flora, also known as the gut microbiota, refers to the diverse community of microorganisms residing in the digestive tract. This complex ecosystem includes bacteria, viruses, fungi, and other microbes. Gut flora plays a vital role in maintaining human health, as it aids in digestion, vitamin production, immune system regulation, and protection against harmful pathogens.

How Antibiotics Affect Gut Flora

Antibiotics, while effective against bacterial infections, are not selective. They can disrupt the balance of gut flora by killing both harmful and beneficial bacteria. This disruption can lead to a decrease in microbial diversity and an overgrowth of opportunistic pathogens. Such imbalances have been associated with various health issues, including antibiotic-associated diarrhea, changes in metabolic function, and increased susceptibility to infections.

Long-Term Implications of Antibiotics on Gut Flora

The long-term implications of antibiotic use on gut flora are still an area of ongoing research. Evidence suggests that repeated or prolonged antibiotic use can lead to persistent alterations in the composition and function of gut flora. These changes may impact overall health and increase the risk of gastrointestinal disorders, allergies, and even chronic diseases. Therefore, strategies to mitigate the effects of antibiotics on gut flora are of great interest.

Benefits of Taking Probiotics with Antibiotics

Taking probiotics concomitantly with antibiotics can offer several advantages. These benefits extend beyond the restoration of gut flora and can positively impact human health in various ways.

Prevention of Antibiotic-Associated Diarrhea (AAD)

One of the most well-known benefits of probiotics when taken with antibiotics is the prevention of antibiotic-associated diarrhea (AAD). AAD is a common side effect of antibiotic use, occurring due to the disruption of gut flora. By introducing probiotics, particularly strains such as Lactobacillus and Bifidobacterium, the risk of developing AAD can be significantly reduced. These probiotics promote a healthy balance of intestinal bacteria and help restore stability to the digestive system.

Restoring Gut Flora Diversity

Alongside preventing AAD, probiotics can aid in restoring gut flora diversity. Antibiotics often deplete certain beneficial bacteria, leading to a reduction in microbial diversity. However, by introducing specific probiotic strains during antibiotic therapy, such as Lactobacillus and Bifidobacterium, the ecosystem can be reestablished, promoting a more balanced and diverse microbial community in the gut.

Boosting Immune System

Probiotics have displayed immune-boosting properties, making them valuable additions to antibiotic therapy. By modulating the immune response, probiotics help enhance the body's defense mechanisms and promote overall immune health. For individuals undergoing antibiotic treatment, supplementing with probiotics can potentially reduce the risk of secondary infections and enhance overall well-being.

Types of Probiotics Recommended with Antibiotics

When considering probiotic supplementation with antibiotics, specific strains have shown promise in terms of their compatibility and efficacy.


Lactobacillus is a probiotic strain commonly found in various dairy products, including yogurt. This strain has been extensively studied and has shown effectiveness in reducing the incidence of AAD and supporting gut health during antibiotic therapy. Lactobacillus can help restore microbial balance and contribute to a healthy immune response.


Similar to Lactobacillus, Bifidobacterium is a probiotic strain recognized for its beneficial effects on gut health. Bifidobacterium species have been extensively investigated for their ability to prevent AAD and support intestinal well-being. These strains have shown promise in maintaining microbial diversity and enhancing immune function.

Saccharomyces boulardii

Saccharomyces boulardii is a yeast that has gained attention for its probiotic properties. This particular strain has been shown to prevent AAD and reduce the risk of antibiotic-induced gastrointestinal disturbances. Saccharomyces boulardii functions by supporting gut barrier integrity and inhibiting the growth of certain pathogens, thereby promoting a healthy gut environment during antibiotic usage.

How to Choose the Right Probiotic Supplement

Choosing the appropriate probiotic supplement to take with antibiotics requires careful consideration of several factors.

Factors to Consider When Choosing a Probiotic

When selecting a probiotic supplement, it is crucial to consider factors such as the specific strains included, the number of live organisms per dose (colony-forming units or CFUs), and the presence of any additional ingredients or potential allergens. Moreover, the viability and stability of the probiotic strains, as well as the manufacturing and storage processes, should also be taken into account to ensure product quality and effectiveness.

Recommended Dosage

The dosage of probiotics can vary depending on the specific strains and the purpose of supplementation. It is essential to follow the manufacturer's recommendations or consult with a healthcare professional for guidance on the appropriate dosage for specific antibiotics or health conditions. Taking the correct dosage is essential to achieve the desired effects and maximize the benefits of probiotic supplementation.

Reputable Probiotic Brands

To ensure the quality and safety of probiotic supplements, it is advisable to choose products from reputable brands. Look for brands that prioritize rigorous testing, adhere to good manufacturing practices, and provide transparent information regarding their products, including the strains used, CFU counts, and any additional certifications or third-party verifications. The reputation and track record of a brand are indicative of its commitment to producing high-quality probiotic supplements.

Probiotic Foods to Consider

In addition to probiotic supplements, certain foods also contain naturally occurring probiotics and can be incorporated into the diet to support gut health while taking antibiotics.


Yogurt is one of the most well-known probiotic foods, containing strains such as Lactobacillus and Bifidobacterium. When choosing yogurt as a source of probiotics, opt for varieties labeled as containing live and active cultures.


Sauerkraut is a fermented cabbage dish that undergoes lactic acid fermentation, resulting in the production of beneficial bacteria, including Lactobacillus species. Adding sauerkraut to meals can introduce probiotics into the diet.


Kimchi, a Korean fermented vegetable dish, similarly offers a rich source of probiotics. Traditionally made with cabbage and various seasonings, kimchi undergoes fermentation that enhances its probiotic content.


Kefir, a fermented milk beverage, contains a combination of bacteria and yeasts that contribute to its probiotic properties. It can be consumed as a drink or used as an ingredient in smoothies or other recipes.


Miso is a traditional Japanese paste made from fermented soybeans, rice, or barley. It contains beneficial bacteria and can be used in soups, marinades, and dressings to incorporate probiotics into the diet.

Timing of Taking Probiotics with Antibiotics

Determining the optimal timing for taking probiotics with antibiotics is an important consideration to maximize their efficacy and minimize potential interactions.

Recommendation from Studies

Studies suggest that taking probiotics concurrently with antibiotics is generally effective in mitigating the negative effects on gut flora. It is advisable to start probiotic supplementation at the beginning of antibiotic treatment to allow the beneficial bacteria to establish themselves in the gut.

The Ideal 'Window' between Antibiotic and Probiotic Intake

While the ideal "window" of time between antibiotic and probiotic intake may vary depending on the specific situation, it is generally recommended to separate the two by a few hours. This interval allows the antibiotics to exert their antimicrobial effects while minimizing potential interactions with probiotics.

Dealing with Different Dosage Schedules

In cases where multiple doses of antibiotics are administered throughout the day, it might be challenging to determine the exact timing for probiotic intake. In such situations, it is important to consult a healthcare professional for personalized advice and guidance regarding the timing and dosage of probiotic supplementation to optimize their effects.

Possible Side Effects of Taking Probiotics with Antibiotics

While probiotics are generally considered safe, there are potential side effects to be aware of, especially when taken concurrently with antibiotics.

Digestive Discomfort

Some individuals may experience mild digestive discomfort, including bloating, gas, or diarrhea, when starting probiotic supplementation. These symptoms are generally temporary and often subside as the body adjusts to the probiotics. However, if they persist or worsen, it is advisable to consult a healthcare professional.

Risk of Infection

In rare cases, particularly in immunocompromised individuals, there is a small risk of infection associated with probiotic use. This risk is higher when using probiotics containing certain strains or in individuals with severe underlying health conditions. As such, it is crucial to consult with a healthcare professional to assess individual risks and benefits.

Interactions with Certain Medications

Probiotics may interact with certain medications, including antibiotics. While the interactions are generally minimal, it is advisable to consult a healthcare professional, especially if taking probiotics alongside antibiotics or other medications. They can provide guidance on potential interactions and adjust treatment plans accordingly.

Consulting Healthcare Professionals

Given the complexity and individuality of health conditions and treatment plans, it is paramount to consult healthcare professionals when incorporating probiotics into antibiotic therapy.

Why It's Important to Consult a Healthcare Professional

Healthcare professionals possess the expertise and knowledge necessary to guide the selection, dosage, and timing of probiotic supplementation. They can assess individual health concerns, evaluate potential interactions, and tailor recommendations based on specific circumstances. Consulting a healthcare professional ensures a personalized approach to probiotic use and optimizes the potential benefits.

The Role of Healthcare Professionals in Guiding Probiotic Use with Antibiotics

Healthcare professionals play a crucial role in guiding probiotic use with antibiotics. They can assess the need for probiotic supplementation based on individual health conditions, educate patients on the benefits and risks, and provide recommendations for specific strains, dosage, and timing. Moreover, healthcare professionals can monitor patients' progress and adjust probiotic regimens as needed, ensuring optimal outcomes.

Getting a Personalized Approach to Probiotics

Every individual's health and microbiome are unique, and therefore, a personalized approach to probiotics is vital. Healthcare professionals can consider the individual's medical history, current health status, and antibiotic treatment plan to recommend probiotics that are suitable and effective for their specific needs. This personalized approach ensures that probiotic supplementation aligns with individual goals and maximizes the potential benefits.

Additional Lifestyle Changes to Support Gut Health

In addition to taking probiotics with antibiotics, adopting certain lifestyle changes can further support gut health and contribute to overall well-being.

Maintaining a Balanced Diet

Consuming a balanced diet that is rich in fruits, vegetables, whole grains, and lean proteins promotes a diverse microbial ecosystem in the gut. Including fiber-rich foods and fermented products in the diet can also support the growth of beneficial bacteria.

Regular Exercise

Regular physical activity has been shown to positively impact gut health. Exercise helps stimulate bowel movements, enhances blood flow to the gut, and promotes a healthy microbial balance. Engaging in regular exercise can contribute to maintaining a healthy gut flora.

Adequate Sleep

Sufficient and quality sleep is essential for overall health and well-being, including gut health. Sleep deprivation or disruption can disturb the balance of gut flora and impair digestive function. Prioritizing adequate sleep can contribute to a healthy and thriving gut microbiome.

Stress Management Techniques

Chronic stress can impact gut health by altering gut flora composition and function. Adopting stress management techniques, such as mindfulness meditation, yoga, or deep breathing exercises, can help reduce stress levels and promote a healthy gut environment.

In conclusion, understanding the relationship between probiotics and antibiotics is crucial for optimizing health outcomes during antibiotic therapy. Probiotics offer numerous benefits, including the prevention of antibiotic-associated diarrhea, restoration of gut flora diversity, and boosting the immune system. When choosing a probiotic supplement, factors such as the specific strains, recommended dosage, and reputable brands should be considered. Additionally, incorporating probiotic-rich foods into the diet, consulting healthcare professionals for personalized advice, and adopting lifestyle changes to support gut health are essential components for achieving and maintaining optimal well-being. By leveraging the power of probiotics alongside antibiotics, individuals can strive for a healthy and balanced microbiome, minimizing the potential negative impacts of antibiotic treatment.



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