Pairing Probiotics and Antibiotics
The intestinal ecosystem is made up of a complex array of microorganisms that are intimately connected to human health. Any disruption to that intestinal bacterial community can mean the difference between symbiosis and dysbiosis.
Antibiotics are designed to kill bacteria and are not sophisticated enough to kill just one type. As a result, both beneficial and nonbeneficial bacteria are eliminated.
The scientific literature features many studies that show probiotics can be taken concurrently with antibiotics. According to a 2018 review published in the Yonsei Medical Journal, there are several mechanisms of action regarding probiotic use before, during and after antibiotic use with some mechanisms not yet fully understood.
Several studies have shown efficacy among children as well. A 2019 Cochrane review gives probiotics a “moderate” rating regarding supporting GI health in children concurrently taking antibiotics.
When it comes to supporting the GI tract concurrently with antibiotic use, a 2015 Cochrane review reports that two of the most studied and effective probiotic strains are Lactobacillus rhamnosus and Saccharomyces boulardii. Other research-backed strains that help support GI health include Lactobacillus acidophilus and Bifidobacterium lactis.
Research shows that patients preparing to take a course of antibiotics can use probiotics to support a healthy microbiome before they start antibiotics. In addition, probiotics can be taken during the course of antibiotic treatment, although it’s best to have a few hours between when the antibiotic is taken and when the probiotic is taken.
It used to be believed that there was no point to this practice, because the probiotic bacteria would be killed by the antibiotic. But recent research has shown that some robust strains e.g. L. rhamnosus Rosell-11 and L. acidophilus Rosell-52 are able to survive to reach the gut alive and that they contribute to keeping the levels of friendly bacteria sufficient, even during concurrent antibiotic use.
Also good to know, is that Saccharomyces boulardii is generally unaffected by antibiotics, which makes it a good probiotic to take concurrent with antibiotic treatment.
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Guo Q, Goldenberg JZ, Humphrey C, et al. Cochrane Database Systematic Reviews. 2019;Apr 30:4.
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Yoon MY, Yoon SS. Yonsei Medical Journal. 2018;59(1):4-12.