Can You Take Probiotics With Antibiotics?
Medically reviewed on April 4, 2024 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Table of contents
- What Happens to the Gut Microbiota on Antibiotics?
- How Do Probiotics Work?
- How to Take Probiotics With Antibiotics
- Support Your Gut Health With Everlywell
Many healthcare providers prescribe antibiotics to treat bacterial infections, such as those that affect the skin, urinary tract, and chest. [1] However, when taken, studies show that these types of medications can seriously disrupt the gut microbiome—the microorganisms that live in the digestive tract and enable proper digestion, cognition, and immune system function. [2]
Accordingly, taking antibiotics requires careful management. [2]
Probiotics, living microorganisms that you can ingest as supplements, might be one tool you can use to help mitigate any adverse effects of antibiotics on gut health. [3]
What Happens to the Gut Microbiota on Antibiotics?
Antibiotics work by killing bacteria in the body, and they’re often taken as a regimen anywhere from seven to 14 days. [4] In most cases, healthcare providers prescribe antibiotics to patients with bacterial infections that are unlikely to resolve on their own or infections that can lead to more serious complications. [1]
Antibiotics’ primary function is also wherein the problem lies.
Studies show that prescribed antibiotic treatments can significantly decrease or fully eradicate certain types of healthy bacteria within the digestive system, which can lead more harmful bacteria, such as Clostridium difficile, to take over—a condition called dysbiosis. As a result, people can experience any of the following [5]:
- Diarrhea
- Constipation
- Obesity
- Malnutrition
- Inflammatory bowel disease
- Neurological dysfunctions
- Cancer
Do antibiotics make you tired? Not typically, but they may cause fatigue or low energy in some individuals. Additional symptoms that can accompany antibiotic treatment include:
- Loss of appetite
- Bloating
- Nausea
- Indigestion
- Abdominal pain
While the gut microbiome can recover on its own within two weeks in young, healthy individuals, continued exposure to antibiotic treatments can significantly prolong the recovery period. [5]
How Do Probiotics Work?
So, can you take probiotics with antibiotics? The answer is yes—but how do probiotics function and what makes them safe (and potentially even beneficial) to take with antibiotics?
Probiotics are pre-portioned supplements that contain live microbes, including the healthy bacteria and yeasts naturally found in the gut. When ingested, they can help to repopulate the gut and manage populations of bad bacteria. [6]
Effectively, probiotics can treat and even prevent dysbiosis. [5] They’re also believed to help prevent and treat antibiotic-associated diarrhea (AAD), which can be fatal in 17 percent of cases. [7]
Specifically, a review of 23 studies that administered one or more of the following strains—Bacillus spp., Bifidobacterium spp., Clostridium butyricum, Lactobacilli spp., Lactococcus spp., Leuconostoc cremoris, Saccharomyces spp., or Streptococcus sp.—found that patients with AAD significantly benefited from probiotics. [8]
That said, the mechanisms by which probiotics change microbial gut composition while taking antibiotics are not yet fully understood, despite extensive research. In many research studies, the results of taking probiotics concurrently with antibiotics vary. [5] In several cases, studies identified that probiotics could prevent some, but not all, changes to the diversity and composition of the gut microbiome. [3]
How to Take Probiotics With Antibiotics
Taking a probiotic supplement alongside an antibiotic may help to mitigate disruptions within the gut microbiome and the accompanying symptoms, such as digestive upset. [8]
To determine what probiotics to take with antibiotics, consider the particular strain of bacteria—some strains can survive alongside antibiotic medications. Probiotic strains that can be taken at the same time as antibiotics include [8]:
- Lactobacillus acidophilus Rosell-52
- Lactobacillus rhamnosus Rosell-11
- Bifidobacterium lactis Lafti B94
Additionally, you’ll want to pay close attention to the number of bacteria per dose (colony-forming units) and how to store the probiotics for optimal effectiveness. Oftentimes, it’s recommended to refrigerate them and avoid areas with high heat. [9]
A commonly suggested guideline is to opt for probiotic products containing a minimum of 1 billion colony-forming units and comprising the genera Lactobacillus, Bifidobacterium, Bacillus, or Saccharomyces boulardii, which are among the most extensively studied probiotic strain. [9]
It’s recommended to take one capsule each day with breakfast. Keep taking the probiotic supplements daily until you complete your antibiotic treatment, and preferably for one week afterward. If your antibiotic treatment lasts longer than a week, continue taking the probiotic until you finish the pack and consider starting a second pack. [8]
You can also opt for probiotic-rich foods that support gut health, such as [9]:
- Yogurt
- Kefir
- Sauerkraut
- Tempeh
- Kimchi
- Miso
- Kombucha
- Pickles
- Buttermilk
- Cheese
Support Your Gut Health With Everlywell
Generally, it’s safe to take probiotic supplements alongside antibiotics as it may help to rebalance and rebuild healthy bacteria within the gut microbiome to prevent such conditions as digestive upset and diarrhea. That said, prescribing probiotic supplementation with antibiotics is still a controversial subject within the scientific community, as some studies suggest that probiotic supplements may actually prolong the recovery period.
Fortunately, Everlywell is here to support your gut health—and your overall health. From at-home Food Sensitivity Tests to virtual telehealth visits, we can help you improve your pain points and provide personalized treatment options from a licensed healthcare provider.
Find your balance today with Everlywell.
Related Content
Doxycycline and Alcohol: Safety Guidelines
Do Antibiotics Make You Tired? Antibiotic Insights
Can You Drink Alcohol on Antibiotics? Potential Risks
References
- NHS inform. Antibiotics | NHS inform. NHS Inform. Published February 19, 2024. Medical Citation URL. Accessed March 26, 2024.
- Patangia DV, Ryan CA, Dempsey EM, Ross RP, Stanton C. Impact of antibiotics on the human microbiome and consequences for host health. MicrobiologyOpen. 2022;11(1). doi:10.1002/mbo3.1260. Medical Citation URL. Accessed March 26, 2024.
- Fernández-Alonso M, Camorlinga AA, Messiah SE, Marroquin EM. Effect of adding probiotics to an antibiotic intervention on the human gut microbial diversity and composition: a systematic review. Journal of Medical Microbiology. 2022;71(11). doi:10.1099/jmm.0.001625. Medical Citation URL. Accessed February 26, 2024.
- Duration of antibiotics prescribed at hospital discharge. PubMed. Published April 1, 2017. Medical Citation URL. Accessed March 26, 2024.
- Éliás AJ, Barna V, Patoni C, et al. Probiotic supplementation during antibiotic treatment is unjustified in maintaining the gut microbiome diversity: a systematic review and meta-analysis. BMC Medicine. 2023;21(1). doi:10.1186/s12916-023-02961-0. Medical Citation URL. Accessed March 26, 2024.
- Probiotics: What you need to know. NCCIH. Last reviewed July 2019. Medical Citation URL. Accessed March 26, 2024.
- PURLs: prescribing an antibiotic? Pair it with probiotics. PubMed. Published March 1, 2013. Medical Citation URL. Accessed March 26, 2024.
- Goldenberg JZ, Lytvyn L, Steurich J, Parkin PC, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. The Cochrane Library. Published online December 22, 2015. doi:10.1002/14651858.cd004827.pub4. Medical Citation URL. Accessed March 26, 2024.
- Clinic C. How to pick the best probiotic. Cleveland Clinic. Published December 18, 2023. Medical Citation URL. Accessed March 26, 2024.
Jordan Stachel, M.S., RDN, CPT is most fulfilled when guiding others towards making stepwise, sustainable changes that add up to big results over time. Jordan works with a wide variety of individuals, ranging in age from children to the elderly, with an assortment of concerns and clinical conditions, and has written for publications such as Innerbody. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.