Should You Take Probiotics While on Antibiotics?

Table of ContentsView AllTable of ContentsCan Probiotics Reduce Side Effects?Can Probiotics Make Antibiotics More Effective?Is It Safe to Take Probiotics?Who Would Benefit?Which Probiotic Strain Should I Take?

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Table of Contents

Can Probiotics Reduce Side Effects?

Can Probiotics Make Antibiotics More Effective?

Is It Safe to Take Probiotics?

Who Would Benefit?

Which Probiotic Strain Should I Take?

Probioticsare livemicroorganisms(microscopic living things such as bacteria, protozoa, algae, and fungi) that can offer various health benefits. You can findprobioticsin different sources, such as dietary supplements and certain foods.

Research suggests that probiotics may help prevent antibiotic-associated diarrhea and reduce the risk ofClostridioides difficile(formerlyClostridium difficile) infection.

If you are taking an antibiotic for a bacterial infection, your healthcare provider may recommend supplementing with a probiotic to support gut health. However, some people may benefit from taking probiotics more than others.

In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. This means some supplement products may not contain what the label says. Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RDN or RD), or pharmacist.

Can Probiotics Reduce Antibiotic-Related Side Effects?

There are many different types of antibiotics, each with its specific side effects. Although antibiotics work on “bad” bacteria, many antibiotics, especially broad-spectrum antibiotics, also disrupt the “good” bacteria.

Recent research suggests that pairing probiotics with antibiotics does not have an effect on generalgut microbiomebalance and diversity. However, probiotics may still be considered in certain cases, such as to preventantibiotic-associated diarrhea.

Research has found the following:

For CDI specifically, a 2017 review of studies found that probiotics can lower the risk of CDI in adults and children who are taking antibiotics. The researchers found that taking probiotics is generally safe, except for people with a suppressed immune system.

However, it is important to consider that having a suppressed immune system is one risk factor for CDI. Therefore, people with a compromised immune system should check with a healthcare provider before using probiotics to prevent CDI.

Probiotics and Premature Infants

Though uncommon, some research suggests that probiotics may improve how well antibiotics work in some cases.

For example, in people withHelicobacter pyloriinfection(a type of bacteria that can cause infection and ulcers in the stomach), taking a probiotic may enhance the effect of the antibiotic, leading to better outcomes and maintaining gut-flora balance.

In general, though, the purpose of taking probiotics with antibiotics is to help prevent diarrhea and CDI rather than improve their effectiveness.

Is Taking Probiotics With Antibiotics Safe for Me?

The best way to know whether taking probiotics with antibiotics is safe for you is to ask your healthcare provider.

The American Gastroenterological Association (AGA) released clinical guidelines on probiotics in digestive disorders. They recommend certain probiotic formulations only in certain situations, one of which is to prevent CDI in adults and children taking antibiotics.

Due to a lack of evidence, the AGA does not recommend that people take probiotics to treat certain conditions, such as:

Also, probiotics may not be appropriate for a person who has a compromised immune system or certain medical conditions. Always check with a healthcare provider before taking a probiotic with an antibiotic or giving your child a probiotic with an antibiotic.

Who Benefits the Most?

Because taking probiotics with antibiotics may reduce the risk of CDI, those who might benefit the most are individuals who are at higher risk for CDI, such as people who:

Check with your healthcare provider before adding a probiotic to your antibiotic treatment.

Adults and children taking antibiotics should check with a healthcare provider before starting a probiotic.

The AGA provides a conditional recommendation (meaning that the recommendation may be suitable for most people but not appropriate for everyone) based on “low-quality evidence” for the following probiotic strains:

You can also ask your healthcare provider or pharmacist for a recommendation.

When Should I Take the Probiotic?

Generally, youtake a probiotic for the entire course of the antibiotic. You can start the probiotic on the same day you start the antibiotic. Experts recommend starting the probiotic within two days of the antibiotic. Your healthcare provider may recommend taking the probiotic at least two hours before or after your antibiotic.

What Foods Contain Probiotics?You may have heard that you should eat yogurt with live and active cultures while taking an antibiotic. According to the International Scientific Association for Probiotics and Prebiotics (ISAPP), some foods, such as yogurt or fermented milk, may contain probiotics. However, it’s important to check the label. Not all fermented foods meet the definition of probiotics, so foods like sauerkraut and kombucha are not considered probiotics.

What Foods Contain Probiotics?

You may have heard that you should eat yogurt with live and active cultures while taking an antibiotic. According to the International Scientific Association for Probiotics and Prebiotics (ISAPP), some foods, such as yogurt or fermented milk, may contain probiotics. However, it’s important to check the label. Not all fermented foods meet the definition of probiotics, so foods like sauerkraut and kombucha are not considered probiotics.

Summary

Probiotics are live microorganisms that can support gut health. Some research suggests that taking probiotics with antibiotics may help prevent antibiotic-associated diarrhea and reduce the risk ofClostridioides difficileinfection (CDI).

People who are at a high risk of CDI, such as people who take long-term antibiotics and those with certain medical conditions, may benefit most from probiotic use. The American Gastroenterological Association recommends specific probiotic strains for preventing CDI, but it is important to consult a healthcare provider before starting probiotics.

14 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.National Center for Complementary and Integrative Health.Probiotics: usefulness and safety.Patangia DV, Ryan CA, Dempsey E, et al.Impact of antibiotics on the human microbiome and consequences for host health.Microbiologyopen. 2022;11(1):e1260. doi:10.1002/mbo3.1260Éliás 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 Med. 2023;21(1):262. doi:10.1186/s12916-023-02961-0.American College of Gastroenterology.Clostridium difficile “C. difficile”infection (CDI).National Institutes of Health Office of Dietary Supplements.Probiotics.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):21. doi:10.3390/antibiotics6040021Hayes SR, Vargas AJ.Probiotics for the prevention of pediatric antibiotic-associated diarrhea.Explore (NY). 2016;12(6):463-466. doi:10.1016/j.explore.2016.08.015Jafarnejad S, Shab-Bidar S, Speakman JR, et al.Probiotics reduce the risk of antibiotic-associated diarrhea in adults (18-64 years) but not the elderly (>65 years): a meta-analysis.Nutr Clin Pract.2016;31(4):502-513. doi:10.1177/0884533616639399Goldenberg JZ, Yap C, Lytvyn L, et al.Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.Cochrane Database Syst Rev. 2017;12(12):CD006095. doi:10.1002/14651858.CD006095.pub4U.S. Food and Drug Administration.FDA raises concerns about probiotic products sold for use in hospitalized preterm infants.Mestre A, Narayanan RS, Rivas D, et al.Role of probiotics in the management ofHelicobacter pylori.Cureus. 2022;14(6):e26463. doi:10.7759/cureus.26463Su GL, Ko CW, Bercik P, et al.AGA Clinical Practice Guidelines on the role of probiotics in the management of gastrointestinal disorders.Gastroenterology. 2020;159(2):697-705. doi:10.1053/j.gastro.2020.05.059MedlinePlus.Lactobacillus acidophilus.Marco ML, Sanders ME, Gänzle M, et al.The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on fermented foods.Nat Rev Gastroenterol Hepatol.2021;18(3):196-208. doi:10.1038/s41575-020-00390-5.

14 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.National Center for Complementary and Integrative Health.Probiotics: usefulness and safety.Patangia DV, Ryan CA, Dempsey E, et al.Impact of antibiotics on the human microbiome and consequences for host health.Microbiologyopen. 2022;11(1):e1260. doi:10.1002/mbo3.1260Éliás 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 Med. 2023;21(1):262. doi:10.1186/s12916-023-02961-0.American College of Gastroenterology.Clostridium difficile “C. difficile”infection (CDI).National Institutes of Health Office of Dietary Supplements.Probiotics.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):21. doi:10.3390/antibiotics6040021Hayes SR, Vargas AJ.Probiotics for the prevention of pediatric antibiotic-associated diarrhea.Explore (NY). 2016;12(6):463-466. doi:10.1016/j.explore.2016.08.015Jafarnejad S, Shab-Bidar S, Speakman JR, et al.Probiotics reduce the risk of antibiotic-associated diarrhea in adults (18-64 years) but not the elderly (>65 years): a meta-analysis.Nutr Clin Pract.2016;31(4):502-513. doi:10.1177/0884533616639399Goldenberg JZ, Yap C, Lytvyn L, et al.Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.Cochrane Database Syst Rev. 2017;12(12):CD006095. doi:10.1002/14651858.CD006095.pub4U.S. Food and Drug Administration.FDA raises concerns about probiotic products sold for use in hospitalized preterm infants.Mestre A, Narayanan RS, Rivas D, et al.Role of probiotics in the management ofHelicobacter pylori.Cureus. 2022;14(6):e26463. doi:10.7759/cureus.26463Su GL, Ko CW, Bercik P, et al.AGA Clinical Practice Guidelines on the role of probiotics in the management of gastrointestinal disorders.Gastroenterology. 2020;159(2):697-705. doi:10.1053/j.gastro.2020.05.059MedlinePlus.Lactobacillus acidophilus.Marco ML, Sanders ME, Gänzle M, et al.The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on fermented foods.Nat Rev Gastroenterol Hepatol.2021;18(3):196-208. doi:10.1038/s41575-020-00390-5.

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.

National Center for Complementary and Integrative Health.Probiotics: usefulness and safety.Patangia DV, Ryan CA, Dempsey E, et al.Impact of antibiotics on the human microbiome and consequences for host health.Microbiologyopen. 2022;11(1):e1260. doi:10.1002/mbo3.1260Éliás 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 Med. 2023;21(1):262. doi:10.1186/s12916-023-02961-0.American College of Gastroenterology.Clostridium difficile “C. difficile”infection (CDI).National Institutes of Health Office of Dietary Supplements.Probiotics.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):21. doi:10.3390/antibiotics6040021Hayes SR, Vargas AJ.Probiotics for the prevention of pediatric antibiotic-associated diarrhea.Explore (NY). 2016;12(6):463-466. doi:10.1016/j.explore.2016.08.015Jafarnejad S, Shab-Bidar S, Speakman JR, et al.Probiotics reduce the risk of antibiotic-associated diarrhea in adults (18-64 years) but not the elderly (>65 years): a meta-analysis.Nutr Clin Pract.2016;31(4):502-513. doi:10.1177/0884533616639399Goldenberg JZ, Yap C, Lytvyn L, et al.Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.Cochrane Database Syst Rev. 2017;12(12):CD006095. doi:10.1002/14651858.CD006095.pub4U.S. Food and Drug Administration.FDA raises concerns about probiotic products sold for use in hospitalized preterm infants.Mestre A, Narayanan RS, Rivas D, et al.Role of probiotics in the management ofHelicobacter pylori.Cureus. 2022;14(6):e26463. doi:10.7759/cureus.26463Su GL, Ko CW, Bercik P, et al.AGA Clinical Practice Guidelines on the role of probiotics in the management of gastrointestinal disorders.Gastroenterology. 2020;159(2):697-705. doi:10.1053/j.gastro.2020.05.059MedlinePlus.Lactobacillus acidophilus.Marco ML, Sanders ME, Gänzle M, et al.The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on fermented foods.Nat Rev Gastroenterol Hepatol.2021;18(3):196-208. doi:10.1038/s41575-020-00390-5.

National Center for Complementary and Integrative Health.Probiotics: usefulness and safety.

Patangia DV, Ryan CA, Dempsey E, et al.Impact of antibiotics on the human microbiome and consequences for host health.Microbiologyopen. 2022;11(1):e1260. doi:10.1002/mbo3.1260

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 Med. 2023;21(1):262. doi:10.1186/s12916-023-02961-0.

American College of Gastroenterology.Clostridium difficile “C. difficile”infection (CDI).

National Institutes of Health Office of Dietary Supplements.Probiotics.

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):21. doi:10.3390/antibiotics6040021

Hayes SR, Vargas AJ.Probiotics for the prevention of pediatric antibiotic-associated diarrhea.Explore (NY). 2016;12(6):463-466. doi:10.1016/j.explore.2016.08.015

Jafarnejad S, Shab-Bidar S, Speakman JR, et al.Probiotics reduce the risk of antibiotic-associated diarrhea in adults (18-64 years) but not the elderly (>65 years): a meta-analysis.Nutr Clin Pract.2016;31(4):502-513. doi:10.1177/0884533616639399

Goldenberg JZ, Yap C, Lytvyn L, et al.Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.Cochrane Database Syst Rev. 2017;12(12):CD006095. doi:10.1002/14651858.CD006095.pub4

U.S. Food and Drug Administration.FDA raises concerns about probiotic products sold for use in hospitalized preterm infants.

Mestre A, Narayanan RS, Rivas D, et al.Role of probiotics in the management ofHelicobacter pylori.Cureus. 2022;14(6):e26463. doi:10.7759/cureus.26463

Su GL, Ko CW, Bercik P, et al.AGA Clinical Practice Guidelines on the role of probiotics in the management of gastrointestinal disorders.Gastroenterology. 2020;159(2):697-705. doi:10.1053/j.gastro.2020.05.059

MedlinePlus.Lactobacillus acidophilus.

Marco ML, Sanders ME, Gänzle M, et al.The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on fermented foods.Nat Rev Gastroenterol Hepatol.2021;18(3):196-208. doi:10.1038/s41575-020-00390-5.

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