Table of ContentsView AllTable of ContentsAntibiotics and Gut FloraTreatmentAntibiotic Resistance
Table of ContentsView All
View All
Table of Contents
Antibiotics and Gut Flora
Treatment
Antibiotic Resistance
Have you ever taken antibiotics for an infection, only to end up with severe diarrhea? It may not have been a bug or something you ate; it could have been a result of an adverse effect of an antibiotic.
The good news is that, in most cases, diarrhea will clear up when the course ofantibioticsis over and a regular diet is resumed. If it doesn’t, your healthcare provider may be able to prescribe treatment to get the bacteria in the digestive tract back in harmony.
Verywell / Emily Roberts
Normally, the small intestine maintains a delicate balance with the billions of bacteria that live inside it. Most of these are the “good bacteria” that aid in digestion and keep “bad bacteria” in check.
Antibiotic-associated diarrhea is more common when:
Occasionally, even a mild, narrow-spectrum antibiotic can cause bowel changes.
AcuteC. difficileinfection is a serious condition that can lead to severe diarrhea,pseudomembranous colitis(inflammation of the large intestine due to an overgrowth ofC. difficile), and a life-threatening emergency known astoxic megacolon.
Do Antibiotics Cause Constipation?
Generally speaking, antibiotic-associated diarrhea will improve once the course of antibiotics is completed. Sometimes it may be necessary to switch to another antibiotic if the symptoms are intolerable.
To prevent dehydration, drink plenty of water (around eight to ten 8-ounce glasses per day) with an occasional sports drink to maintain electrolyte levels. Chicken and beef broth help to replace sodium, while fruit juice and soda pop help replace lost potassium.
Because diarrhea is actually clearing the body of the infection, healthcare providers do not usually prescribeantidiarrheal medicationsunless there is no other choice or if the antibiotic is being given for an infection that is not GI-related (such as for strep).
If aC difficileinfection is confirmed, the antibiotics metronidazole and vancomycin may be prescribed to kill the bacteria and restore the normal digestive flora.
Prevention efforts would be needed to avoid the spread of infection. This includes good hand-washing practices and the disinfecting of any surface or object that may have been accidentally contaminated with stool.
Role of Probiotics
Studies have shown replacing the good bacteria in the gut also can be helpful in treating diarrhea.Lactobacillusis a bacteria found in many yogurts with live active culturescultures, in acidophilus milk, and as a supplement.
According to a 2015 study from the University of Copenhagen, which analyzed 17 randomized controlled trials involving 3,631 adults, probiotic supplements halved the risk of antibiotic-associated diarrhea compared to no treatment at all (8.8% versus 17.7%).
In 2020, the American Gastroenterology Association released a statement suggesting some adults and children on antibiotic treatment may benefit from taking a probiotic as a measure to help prevent infection withC. difficilebacteria.Usually, probiotics should be taken within 24 hours of antibiotic use.
It is important to follow your healthcare provider’s instructions when prescribed a course of antibiotics. Set up reminders on your cell phone so that you don’t miss a dose. If you do, take the dose immediately but do not double-dose to catch up. Doing so may increase the risk of diarrhea and other drug side effect.
Most importantly, always finish the entire course even if you feel better. Not finishing the whole course can lead to the development of antibiotic resistance.
Stopping antibiotics before an infection is cleared allows resistant bacteria to persist and multiply. If the infection reoccurs, the mutant strain may be fully or partially resistant to the antibiotic, making it all the more difficult to cure.
A 2017 update in theJournal of Clinical Microbiologyreported that the rate of moxifloxacin-resistantC. difficilealready hovers between 2% and 87% depending on where you live.
A Word From Verywell
In some cases, healthcare providers will recommend that probiotics be added to your diet while taking antibiotics. Hand-washing can prevent further spread of infection, especially among those who are ill or in hospital.
Severe diarrhea should never be ignored or self-treated with anti-diarrheal drugs. Doing so can make the underlying infection more difficult to treat and may result in constipation, which can be no less distressing.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Predrag S.Analysis of risk factors and clinical manifestations associated withClostridium difficiledisease in Serbian hospitalized patients.Braz J Microbiol. 2016;47(4):902-10. doi:10.1016/j.bjm.2016.07.011Al-Jashaami LS, Dupont HL.Management ofClostridium difficileinfection.Gastroenterol Hepatol (N Y). 2016;12(10):609-16.Blaabjerg S, Artzi DM, Aabenhus R.Probiotics for the prevention of antibiotic-associated diarrhea in outpatients—a systematic review and meta-analysis.Antibiotics (Basel).2017;6(4):29023420. doi:10.3390/antibiotics6040021Su G, Ko C, Bercik, P, et al.AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders.Gastroenterology. June 9 2020.doi.org/10.1053/j.gastro.2020.05.059Peng Z, Jin D, Kim HB, et al.Update on antimicrobial resistance in Clostridium difficile: resistance mechanisms and antimicrobial susceptibility testing.J Clin Microbiol.2017;55(7):1998-2008. doi:10.1128/JCM.02250-16
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Predrag S.Analysis of risk factors and clinical manifestations associated withClostridium difficiledisease in Serbian hospitalized patients.Braz J Microbiol. 2016;47(4):902-10. doi:10.1016/j.bjm.2016.07.011Al-Jashaami LS, Dupont HL.Management ofClostridium difficileinfection.Gastroenterol Hepatol (N Y). 2016;12(10):609-16.Blaabjerg S, Artzi DM, Aabenhus R.Probiotics for the prevention of antibiotic-associated diarrhea in outpatients—a systematic review and meta-analysis.Antibiotics (Basel).2017;6(4):29023420. doi:10.3390/antibiotics6040021Su G, Ko C, Bercik, P, et al.AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders.Gastroenterology. June 9 2020.doi.org/10.1053/j.gastro.2020.05.059Peng Z, Jin D, Kim HB, et al.Update on antimicrobial resistance in Clostridium difficile: resistance mechanisms and antimicrobial susceptibility testing.J Clin Microbiol.2017;55(7):1998-2008. doi:10.1128/JCM.02250-16
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Predrag S.Analysis of risk factors and clinical manifestations associated withClostridium difficiledisease in Serbian hospitalized patients.Braz J Microbiol. 2016;47(4):902-10. doi:10.1016/j.bjm.2016.07.011Al-Jashaami LS, Dupont HL.Management ofClostridium difficileinfection.Gastroenterol Hepatol (N Y). 2016;12(10):609-16.Blaabjerg S, Artzi DM, Aabenhus R.Probiotics for the prevention of antibiotic-associated diarrhea in outpatients—a systematic review and meta-analysis.Antibiotics (Basel).2017;6(4):29023420. doi:10.3390/antibiotics6040021Su G, Ko C, Bercik, P, et al.AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders.Gastroenterology. June 9 2020.doi.org/10.1053/j.gastro.2020.05.059Peng Z, Jin D, Kim HB, et al.Update on antimicrobial resistance in Clostridium difficile: resistance mechanisms and antimicrobial susceptibility testing.J Clin Microbiol.2017;55(7):1998-2008. doi:10.1128/JCM.02250-16
Predrag S.Analysis of risk factors and clinical manifestations associated withClostridium difficiledisease in Serbian hospitalized patients.Braz J Microbiol. 2016;47(4):902-10. doi:10.1016/j.bjm.2016.07.011
Al-Jashaami LS, Dupont HL.Management ofClostridium difficileinfection.Gastroenterol Hepatol (N Y). 2016;12(10):609-16.
Blaabjerg S, Artzi DM, Aabenhus R.Probiotics for the prevention of antibiotic-associated diarrhea in outpatients—a systematic review and meta-analysis.Antibiotics (Basel).2017;6(4):29023420. doi:10.3390/antibiotics6040021
Su G, Ko C, Bercik, P, et al.AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders.Gastroenterology. June 9 2020.doi.org/10.1053/j.gastro.2020.05.059
Peng Z, Jin D, Kim HB, et al.Update on antimicrobial resistance in Clostridium difficile: resistance mechanisms and antimicrobial susceptibility testing.J Clin Microbiol.2017;55(7):1998-2008. doi:10.1128/JCM.02250-16
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