Yes, you can take probiotics during or after a dose of antibiotics. In fact, some doctors recommend it. Here's why probiotics can help you get back on track and the best time to take them. Show
How antibiotics workIf you have a bacterial infection, like strep throat or a UTI, your doctor will likely prescribe you an antibiotic for treatment. The purpose of the antibiotic is to destroy the harmful bacteria that are making you sick. However, antibiotics don't know the difference between harmful bacteria and the helpful bacteria in your gut that comprise your microbiome. Therefore, as they work to make you better, antibiotics can also disrupt both the balance and amount of good bacteria in your gut. Research has shown that certain changes in intestinal bacteria can be associated with a higher risk of diseases like obesity, inflammatory bowel disease, diabetes, and depression. It is not yet fully clear whether these changes are causal or simply result from the same metabolic predispositions that cause these. However, it's safe and often recommended to take probiotics during and after a course of antibiotics, since they can decrease some of the side effects of antibiotics. "Probiotics are live microorganisms. They are generally safe to consume," says Rudolph Bedford, MD, a gastroenterologist at Providence Saint John's Health Center. Probiotics can be taken as a supplement or you can get them by consuming fermented foods and drinks like yogurt, kombucha, and kimchi. The best time to take probiotics: during and after treatmentBedford recommends that you start taking probiotics the same day as an antibiotic treatment. While you're on antibiotics, take those first before the probiotics. Don't take them at the exact same time because the antibiotics could destroy the bacteria from the probiotic and cancel out any beneficial effects, Bedford says. "You don't want the probiotic on board until a couple of hours after the antibiotic itself is taken," says Bedford. Moreover, Bedford highly recommends that you continue to take probiotics for two weeks after you've completed your antibiotic dose to get your gut microbiome back to normal. Take probiotics to reduce antibiotic-associated diarrheaDiarrhea is a common side effect of antibiotics. However, preliminary research suggests that taking probiotics may help prevent antibiotic-associated diarrhea (AAD). For example, one review of 17 studies found that taking a probiotic may reduce the risk of developing AAD by 51%. Moreover, some antibiotics can leave you more vulnerable to certain infections, like Clostridium difficile (C. diff). This is a bacterial infection that can cause diarrhea, an inflamed colon, and, in severe cases death. However, preliminary research found that taking probiotics may help prevent diarrhea from C. diff infections, though the correlation was weak. For example, based on a review of 31 studies, researchers report that one case of diarrhea for every 42 C. diff-infected patients may be prevented from taking probiotics. As for what type of probiotic to take, one option is a yeast called Saccharomyces boulardii CNCM I-745, sold under the brand name Florastar. This probiotic supplement is used to help prevent and treat diarrhea. Those who are immunocompromised may not benefit from probiotics and should discuss other options with a doctor. Insider's takeawayIt may be a good idea to take probiotics with antibiotics in order to deal with the uncomfortable symptoms of antibiotics like diarrhea. You can also get the same benefits of probiotics by eating naturally probiotic foods like yogurt, kombucha, and kimchi. Ashley Laderer Ashley Laderer is a freelance writer from New York who specializes in health and wellness. Follow her on Twitter @ashladerer The good news is that evidence suggests taking probiotics alongside antibiotics may help to reduce adverse effects on the composition of the gut microbiome19. Read on to find out more about the best probiotics for antibiotics. In this article we will look at the following:  Can I take probiotics with antibiotics?Yes. Extensive clinical research suggests the best probiotic to take with antibiotics are particular strains that can be taken alongside antibiotics, rather than separately. These particular strains are Lactobacillus acidophilus Rosell-52, Lactobacillus rhamnosus Rosell-11 and Bifidobacterium lactis Lafti B94. These strains can be taken at exactly the same time as antibiotic medication, which is not the case for most other probiotic supplements. Health professionals can read this article about research using a probiotic for antibiotics. It’s not necessarily bad or counterproductive to take other probiotic strains alongside antibiotic medication, it just means that the probiotic may not be viable, but rest assured, the antibiotic medication itself would not be affected. It’s always good to take strains of probiotics that have been studied to help with the health concern or situation you are looking to support as not all probiotics are the same. Taking well-studied strains that have been shown to survive when taken at the same time as the antibiotic medication is particularly useful alongside intravenous (IV) antibiotics which may be constantly administered on a drip. We would always say that it is a good idea to take probiotics during and after courses of antibiotics. Taking probiotics after antibiotics is discussed later in this article. Which are the best probiotics to take alongside antibiotics?A question we often get asked is, which are the best probiotics with antibiotics, in terms of the associated diarrhoea? As seen above, it seems that this is the main area of concern when taking this type of medication. It’s important to select strains of probiotics that have been tested in clinical trials and have been shown to reach the gut alive when taken alongside antibiotics. The more friendly bacteria present in the gut, the lower the chance of developing digestive issues like diarrhoea. Three strains of probiotics in particular, Lactobacillus acidophilus Rosell-52, Lactobacillus rhamnosus Rosell-11 and Bifidobacterium lactis Lafti B94 have been shown to do this. They can safely be taken at exactly the same time as antibiotic medication. The recommended use for a supplement containing this probiotic combination is as follows:
In clinical trials involving those undergoing antibiotic treatment for Helicobacter pylori infection, participants were given Lactobacillus acidophilus Rosell-52, Lactobacillus rhamnosus Rosell-11 and Bifidobacterium lactis Lafti B94 alongside antibiotics; all three strains were proven to survive alongside the medication11,12. Those taking antibiotics for a vaginal health issue might also like to consider taking probiotic strains which are well researched for intimate health, such as Lactobacillus reuteri RC-14® and Lactobacillus rhamnosus GR-1®. These strains are often used alongside antibiotics for vaginal infections but are best taken 2 hours away from the medication. Probiotics for children taking antibioticsMany parents first start giving probiotic supplements to their children when they are given a course of antibiotics, as this type of medication can sometimes cause tummy upsets. Children aged one year and above are fine to take the above mentioned strains, Lactobacillus acidophilus Rosell-52, Lactobacillus rhamnosus Rosell-11 and Bifidobacterium lactis Lafti B94, as they have also been clinically trialled in children. It can be easier to use these strains , as there's no need to give them at a different time to the antibiotics. However, if their child is already taking a probiotic supplement especially formulated for children’s gut health, parents can opt to continue giving this with food a couple of hours away from the medication. Do antibiotics kill probiotics?Unfortunately, only a few probiotic strains have been shown to survive when taken directly alongside antibiotics. As all antibiotic medication will have some kind of negative impact on the gut microbiome, it’s really important to choose the right strains of probiotics when taking this type of medication. You want strains that have not only been researched to survive when directly taken alongside antibiotics, but to also demonstrate that they exert benefits. The extensive research behind the three previously mentioned Lactobacillus strains sets them apart from many probiotic supplements on the market today and makes them a suitable choice for anyone who wishes to take natural bacteria during their course of antibiotics. Furthermore, Lactobacillus acidophilus Rosell-52, Lactobacillus rhamnosus Rosell-11 and Bifidobacterium lactis Lafti B94 have been tested and shown in-vitro to survive stomach acidity and bile salts. Alternatives to antibiotics would, of course, be interesting to explore but ideally, in the case of a bacterial infection, this should be under the supervision of a healthcare practitioner. It is worth considering that antibiotics are not always necessary, for example in the case of viral infections, antibiotics will remain ineffective (because antibiotics, by nature, target bacteria). There are also arguably a number of minor bacterial infections that have the potential to resolve naturally without having to rely on an antibiotic. Of note, up to 42% of uncomplicated urinary tract infections may clear spontaneously within 48 hours, especially when helped along with plenty of water17. Probiotics vs Antibiotics? You’re asking the wrong question.The question of whether someone should be taking a probiotic or an antibiotic is commonly asked. The answer, in short, is that it isn't a question of either/or! but instead, whether a probiotic should be taken in addition to, or alongside, an antibiotic. The answer to this question is, in most cases, yes! Is it ever a question of probiotics OR antibiotics?There are some conditions where those afflicted may prefer trying natural interventions first. Acne is a very common skin issue where antibiotics are often prescribed as a treatment by a general practitioner or dermatologist. In a 2011 literature review, it was determined that there is sufficient supportive evidence to suggest that gut microbes, and the health of the gastrointestinal tract itself, may be contributing factors in acne vulgaris3. You may like to read our FAQ about probiotics and skin health. However, this decision should always be made in line with a doctor’s consent. Important tips for supporting general health whilst on antibiotics
Key takeaways: probiotics and antibiotics
To find out more about the research behind our strains, health professionals can visit their entries on the Probiotics Database: Lactobacillus acidophilus NCFM®, Lactobacillus acidophilus Rosell-52 and Lactobacillus rhamnosus Rosell-11, Lactobacillus reuteri RC-14® and Lactobacillus rhamnosus GR-1®. Can you take Florastor with your antibiotic?The use of Florastor once daily during your course of antibiotics will significantly reduce the incidence of diarrhea. A further complication of taking antibiotics is the development of C. Diff, a particularly difficult bacterial strain that damages the colon and in some cases can result in hospitalization and death.
Can you take probiotics and antibiotics at the same time?PRACTICE CHANGER. Recommend that patients taking antibiotics also take probiotics, which have been found to be effective both for the prevention and treatment of antibiotic-associated diarrhea (AAD). A: Based on a systematic review and meta-analysis of randomized controlled trials. Hempel S, Newberry S, Maher A, et al.
How long should you wait between probiotics and antibiotics?Doctors who recommend probiotics typically suggest that people take them a few hours after their antibiotic. Otherwise, the two medications can cancel each other out. Some doctors even suggest waiting to start probiotics until a few days after you've completed your course of antibiotics.
Does Florastor interact with any medications?There are 233 drugs known to interact with Florastor (saccharomyces boulardii lyo), along with 2 disease interactions. Of the total drug interactions, 233 are moderate.
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Can you take florastor and antibiotics at the same time
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