Allantibioticshave the potential to causediarrhea, which can range from mild to severe.Some classes of antibiotics are more likely to cause this side effect than others.
Some antibiotics that pose a high or moderate risk of diarrhea include:
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Knowing which antibiotics are most likely to cause diarrhea can help you and your healthcare provider decide which one may be best for you the next time you need to treat a bacterial infection. This may be particularly important to you for practical reasons, but also if you have certain health conditions.
This article explains why antibiotics cause diarrhea and which ones are most likely to cause it. It also discusses howtaking probiotics along with antibioticscan help to prevent antibiotic-associated diarrhea.
Why Antibiotics Cause Diarrhea
When you have a bacterial infection such asstrep throator aurinary tract infection, your healthcare provider may prescribe an antibiotic to kill the pathogen causing the illness. But antibiotics act throughout your body and may kill both the bacteria that keep you healthy and that which causes illness.
That alters the way your intestine handles nutrients and fluids. It also changes its motility, or the way it contracts to move material through. When that happens, many people develop diarrhea.
In most cases, this diarrhea will be mild and clear up quickly once you have ended your course of antibiotics.
Verywell / Emily Roberts
C. Difficile-Associated Diarrhea
In a small number of people (1% to 3% of healthy adults), a bacteria calledClostridioides difficile(C. difficile or C .diff)lives in the colon.
In a minority of those people,C. difficilemay begin to multiply and take over the colon after a course of antibiotics. This can, unfortunately, result inC. diff-associated diarrhea (also called pseudomembranous colitis).
In rare cases, this may also be associated withtoxic megacolon, which is a life-threatening surgical emergency.
Symptoms of C. Difficile Infection
Antibiotics Most Likely to Cause Diarrhea
While any antibiotic can result in either mild diarrhea orC. difficilecolitis, some have a higher risk of doing so than others. The antibiotics formulated to kill a wide variety of bacteria (both the good and the bad) are more likely to have this effect.
Highest amount of risk:
Moderate amount of risk:
Lowest risk:
Tetracyclinehas shown no increased risk of diarrhea.
Probiotics for Prevention
Probiotics are naturally occurring so-called “friendly” bacteria that help promote a healthy gut. Besides those that reside in the body, probiotics can be consumed in yogurt and fermented foods, and are also widely available over the counter as supplements.
Although limited, there is research to suggest taking probiotics can help to significantly lower the risk of antibiotic-related diarrhea.Lactobacillus rhamnosusGGandSaccharomyces boulardiistrains appear to be particularly effective.
The American Gastroenterology Association (AGA) 2020 clinical practice guidelines conditionally recommend the use of certain probiotic strains and combinations of strains over no or other probiotic strains in the prevention ofC. difficileinfection for adults and children on antibiotic treatment.
In its recommendation, the AGA notes that people concerned about potential harms, those who want to avoid the associated cost and those generally unconcerned about developingC. difficilecan reasonably choose to forgo probiotics altogether.
Talk to your healthcare provider before starting probiotics or any other supplements.
What Is Probiotic Acidophilus?
IBD and Antibiotics
If you haveinflammatory bowel disease (IBD), especially with an ostomy or aJ-pouch, it is important to talk to agastroenterologistabout antibiotics.
While various antibiotics have been explored as treatments for some types of IBD or its complications, antibiotics have been also been associated with IBD flare-ups and an increased risk ofC. difficileinfection.
If you have IBD and are thinking of using a probiotic to repopulate your digestive system after a course of antibiotics, discuss it with your gastroenterologist first.
Treating Diarrhea From Antibiotic Use
A Word From VerywellAside from the commonly known management methods for antibiotic-associated diarrhea, such as rehydration and a bland diet, also remember that certain antibiotics pose a higher risk, dietary adjustments can be crucial, and preventative measures are key.—KASHIF J. PIRACHA, MD
A Word From Verywell
Aside from the commonly known management methods for antibiotic-associated diarrhea, such as rehydration and a bland diet, also remember that certain antibiotics pose a higher risk, dietary adjustments can be crucial, and preventative measures are key.—KASHIF J. PIRACHA, MD
Aside from the commonly known management methods for antibiotic-associated diarrhea, such as rehydration and a bland diet, also remember that certain antibiotics pose a higher risk, dietary adjustments can be crucial, and preventative measures are key.
—KASHIF J. PIRACHA, MD
11 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.U.S. National Library of Medicine: MedlinePlus.Antibiotics.Mayo Clinic.Antibiotic-associated diarrhea.Hansen MP, Scott AM, McCullough A, et al.Adverse events in people taking macrolide antibiotics versus placebo for any indication.Cochrane Database Syst Rev. 2019;1(1):CD011825. doi:10.1002/14651858.CD011825.pub2Harvard Health Publishing.Antibiotic-associated diarrhea.Abad CLR, Safdar N.A review ofClostridioides difficileinfection and antibiotic-associated diarrhea.Gastroenterol Clin North Am. 2021;50(2):323–40. doi:10.1016/j.gtc.2021.02.010Teng C, Reveles KR, Obodozie-Ofoegbu OO, Frei CR.Clostridium difficileInfection risk with important antibiotic classes: An analysis of the FDA adverse event reporting system.Int J Med Sci. 2019;16(5):630–635. doi:10.7150/ijms.30739Brown KA, Khanafer N, Daneman N, Fisman DN.Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection.Antimicrob Agents Chemother. 2013;57(5):2326-32.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:CD006095.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/antibiotics6040021Su 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.2020.05.059Nitzan O, Elias M, Peretz A, Saliba W.Role of antibiotics for treatment of inflammatory bowel disease.World J Gastroenterol. 2016;22(3):1078–1087. doi:10.3748/wjg.v22.i3.1078
11 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.U.S. National Library of Medicine: MedlinePlus.Antibiotics.Mayo Clinic.Antibiotic-associated diarrhea.Hansen MP, Scott AM, McCullough A, et al.Adverse events in people taking macrolide antibiotics versus placebo for any indication.Cochrane Database Syst Rev. 2019;1(1):CD011825. doi:10.1002/14651858.CD011825.pub2Harvard Health Publishing.Antibiotic-associated diarrhea.Abad CLR, Safdar N.A review ofClostridioides difficileinfection and antibiotic-associated diarrhea.Gastroenterol Clin North Am. 2021;50(2):323–40. doi:10.1016/j.gtc.2021.02.010Teng C, Reveles KR, Obodozie-Ofoegbu OO, Frei CR.Clostridium difficileInfection risk with important antibiotic classes: An analysis of the FDA adverse event reporting system.Int J Med Sci. 2019;16(5):630–635. doi:10.7150/ijms.30739Brown KA, Khanafer N, Daneman N, Fisman DN.Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection.Antimicrob Agents Chemother. 2013;57(5):2326-32.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:CD006095.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/antibiotics6040021Su 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.2020.05.059Nitzan O, Elias M, Peretz A, Saliba W.Role of antibiotics for treatment of inflammatory bowel disease.World J Gastroenterol. 2016;22(3):1078–1087. doi:10.3748/wjg.v22.i3.1078
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.
U.S. National Library of Medicine: MedlinePlus.Antibiotics.Mayo Clinic.Antibiotic-associated diarrhea.Hansen MP, Scott AM, McCullough A, et al.Adverse events in people taking macrolide antibiotics versus placebo for any indication.Cochrane Database Syst Rev. 2019;1(1):CD011825. doi:10.1002/14651858.CD011825.pub2Harvard Health Publishing.Antibiotic-associated diarrhea.Abad CLR, Safdar N.A review ofClostridioides difficileinfection and antibiotic-associated diarrhea.Gastroenterol Clin North Am. 2021;50(2):323–40. doi:10.1016/j.gtc.2021.02.010Teng C, Reveles KR, Obodozie-Ofoegbu OO, Frei CR.Clostridium difficileInfection risk with important antibiotic classes: An analysis of the FDA adverse event reporting system.Int J Med Sci. 2019;16(5):630–635. doi:10.7150/ijms.30739Brown KA, Khanafer N, Daneman N, Fisman DN.Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection.Antimicrob Agents Chemother. 2013;57(5):2326-32.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:CD006095.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/antibiotics6040021Su 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.2020.05.059Nitzan O, Elias M, Peretz A, Saliba W.Role of antibiotics for treatment of inflammatory bowel disease.World J Gastroenterol. 2016;22(3):1078–1087. doi:10.3748/wjg.v22.i3.1078
U.S. National Library of Medicine: MedlinePlus.Antibiotics.
Mayo Clinic.Antibiotic-associated diarrhea.
Hansen MP, Scott AM, McCullough A, et al.Adverse events in people taking macrolide antibiotics versus placebo for any indication.Cochrane Database Syst Rev. 2019;1(1):CD011825. doi:10.1002/14651858.CD011825.pub2
Harvard Health Publishing.Antibiotic-associated diarrhea.
Abad CLR, Safdar N.A review ofClostridioides difficileinfection and antibiotic-associated diarrhea.Gastroenterol Clin North Am. 2021;50(2):323–40. doi:10.1016/j.gtc.2021.02.010
Teng C, Reveles KR, Obodozie-Ofoegbu OO, Frei CR.Clostridium difficileInfection risk with important antibiotic classes: An analysis of the FDA adverse event reporting system.Int J Med Sci. 2019;16(5):630–635. doi:10.7150/ijms.30739
Brown KA, Khanafer N, Daneman N, Fisman DN.Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection.Antimicrob Agents Chemother. 2013;57(5):2326-32.
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:CD006095.
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
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
Nitzan O, Elias M, Peretz A, Saliba W.Role of antibiotics for treatment of inflammatory bowel disease.World J Gastroenterol. 2016;22(3):1078–1087. doi:10.3748/wjg.v22.i3.1078
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