May 20, 2022

Can I take probiotics with antibiotics?

Do opposites attract or cancel each other out? We asked the experts for the end result.

In short: Yes, you can take a probiotic while you’re taking an antibiotic, it’s perfectly safe. In fact, experts generally agree that probiotics can help prevent the gut reaction that comes from taking antibiotics (such as diarrhea), but the data is limited. On the other hand, to reap the maximum gut flora-restoring benefits that probiotics offer, it may be best to wait until your antibiotic treatment is finished before you start taking them, says Eric Goldberg, MD, internist and physician. director of NYU Langone Internal Medicine Associates in New York.

To understand how probiotics and antibiotics work together, let’s first talk about the gut microbiome. The microbiome is where billions of bacteria, fungi and viruses live. We all have a balance of good and bad bacteria in our gut microbiome. When levels of harmful bacteria get too high, you get sick, in the form of stomach ‘bugs’, fungal infections and a knock on your immune system, making you more susceptible to infection. future.

How do antibiotics work?

You probably know that antibiotics are drugs that kill harmful bacteria that cause infections such as strep throat or a urinary tract infection. Broad-spectrum antibiotics, such as amoxicillin or tetracycline, target several strains of bacteria at once. Newer narrow-spectrum antibiotics (such as erythromycin and clindamycin) target a more limited range of organisms. The downside to both is that they can also kill good bacteria, but broad-spectrum antibiotics carry the greatest risk. When the good bacteria are eliminated, you may have an upset stomach with loose stools, a phenomenon known as antibiotic-associated diarrhea (AAD). Also, women who are prone to yeast infections can get one after a course of antibiotics, as fungi can grow in the genital area without enough good gut flora.

What are probiotics?

Probiotics, on the other hand, seek to pre-load your gut with live microorganisms that are known to fight inflammation, improve immune response and destroy disease-causing cells, according to the National Center for Complementary and Integrative Health. It’s basically the “good bacteria” in your gut that can be affected when you take antibiotics.

So, while considered safe, taking probiotics and antibiotics at the same time can be counterproductive, says Dr. Goldberg. “The antibiotic probably kills whatever the probiotic adds,” he says. However, taking probiotics near the end of your course of antibiotics (which usually lasts about a week) ensures that the antibiotic has had time to do its job properly. As the antibiotics in your system diminish, you can begin to repopulate the beneficial insects.

However, not everyone agrees with this theory: Alia Aaeedy, director of pharmacy at Texas Surgical Hospital in Plano, Texas, says some research suggests that antibiotics and probiotics can be taken in the same window of days as long as you separate your doses by two to three hours to avoid the cancellation factor.

How to take probiotics

How long after stopping an antibiotic should you continue to take your probiotic? Experts say one to four weeks, but the research is unclear. A study published in the journal Cell found that participants who took a probiotic for four weeks after an antibiotic were able to restore their gut microbiome to normal after six months; the placebo group, however, colonized new healthy gut bacteria in just three weeks. (Researchers say it’s possible the particular blend of probiotics in the study was not effective on that particular antibiotic and more research is needed to confirm the results.)

The result here? The benefits of taking a probiotic with or after an antibiotic aren’t 100% confirmed, but there are few downsides to trying it. Stick to the most studied strains such as Lactobacillus, Bifidobacteriumand Saccharomyces. Look for supplements with the USP seal, a dietary supplement certification that guarantees the bottle contains what it says. The FDA does not regulate probiotics, so some legwork is essential. You can also eat your probiotics in foods and drinks containing active and fermented cultures such as yogurt, sauerkraut, miso and kefir.

Krista Bennett De Maio

Meet our writer

Krista Bennett De Maio

Krista Bennett DeMaio has over a decade of editorial experience. The former magazine editor-turned-freelance writer regularly covers skincare, health, beauty and lifestyle topics. His work has been published in national publications and websites, including Oprah, women’s health, red book, Shape, Dr Oz The Good Life, bhg.com and prevention.com. She lives in Huntington, New York with her husband and three daughters.