Should I Take Probiotics with Antibiotics?

I don’t get sick often but when I do, it hits me hard. I have a history with Strep throat, in particular, which means I end up taking an antibiotic. In the hospital, I have seen a young person (30 years or younger) have heart-related complications due to Strep; I do not treat it as if I would a virus that I would do my best to get over as naturally as possible.

When put on antibiotics, as a nutrition professional, I have to question the effectiveness of taking probiotics while taking antibiotics.   According to Harvard, “Since the mid-1990s, clinical studies have established that probiotic therapy can help treat several gastrointestinal ills, delay the development of allergies in children, and treat and prevent vaginal and urinary infections in women”. After all, a significant percentage of our immune function is related to the wall of our gut!

A recent meta-analysis did find a reduction in antibiotic-related side effects. With research such as this making an appearance, many food products being touted with having healthy probiotics, many health professionals encouraging patients to take probiotics, and few reported negative side effects to taking them, it’s easy to see why many would choose to take probiotic supplements with or without taking antibiotics.

Many foods, such as yogurt, kefir, and sauerkraut, contain probiotics; however, these may not contain enough or the right culture for every individual. If you’re a generally healthy individual and you don’t experience GI side effects from taking antibiotics, increasing your intake of foods that contain probiotics might be beneficial if you are inclined to do so. If you do suffer from side effects, such as diarrhea, from taking antibiotics, the meta-analysis above indicates that you might benefit from increasing your intake of probiotics and possibly reduce such side effects.

Ideal times for taking probiotics are to be considered, as well. It is generally recommended to wait 2 hours after taking the antibiotic before taking a probiotic. Due to gut pH, meal times, particularly breakfast, may be ideal for taking probiotics to ensure they reach the intestines to be most effective.  However, some individuals may not tolerate taking probiotics in the morning but tolerate taking their probiotics at dinner or in the evening with a snack. Certain antibiotics and probiotics must be taken separately; make sure to ask your provider about this. Probiotics are not recommended to be consumed with hot beverages.

Keep in mind, this is not medical advice; you should always check with your health provider before making changes to your diet, including taking supplements. Some people may have allergies or intolerances to certain probiotic cultures. Some individuals may benefit from a certain culture or variety of cultures depending on their individual gut flora. Price is something to consider and may not indicate quality of the product. The consumer market has many brands to choose from with few having clinical data to support their claims. While I do not recommend, or receive financial or other gains from/because of, a specific product, I will say that Florastor has some research behind it. I would, of course, recommend researching a particular product you are interested in.

As for me, I will increase my intake of probiotic foods that I regularly enjoy and continue to take my prenatal vitamin that includes a probiotic blend.

For more information on the study above and other probiotic information I referenced or reviewed for this post, please visit the links below:

Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea:  A Systematic Review and Meta-analysis

Harvard Family Health Guide: Health Benefits of Taking Probiotics

Dr. Weil: Probiotics

National Center for Complementary and Alternative Medicine

Nutritionally yours,

Julie Wallace, RDN, LDN

Disclaimer: All information here is for educational purposes only. Individuals should speak with their health providers regarding changes made to their diets and physical activity. Please visit eatright.org to find a dietitian who can assist you with dietary changes.

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