What medication should be used to protect the gut while on antibiotics?

From the Guidelines

Probiotics, specifically those containing Lactobacillus rhamnosus ATCC 53103, are recommended to protect the gut while taking antibiotics. According to a recently published network meta-analysis 1, L rhamnosus ATCC 53103 had the highest probability of being the top-ranked intervention in terms of both effectiveness and tolerability for preventing antibiotic-associated diarrhea.

Key Considerations

• Take the probiotic supplement at least 2 hours before or after your antibiotic dose to prevent the antibiotic from killing the beneficial bacteria.
• Continue taking the probiotic during your entire course of antibiotics and for 1-2 weeks afterward.
• Typical dosages range from 5-10 billion CFUs daily for children and 10-20 billion CFUs daily for adults.
• Probiotics help maintain healthy gut flora by replenishing beneficial bacteria that antibiotics may destroy, which reduces the risk of antibiotic-associated diarrhea and other digestive disturbances.
• Other effective probiotic strains include Saccharomyces boulardii, as well as specific combinations of Lactobacillus and Bifidobacterium strains 1.

Additional Guidance

• Some people also find that consuming yogurt with live cultures or fermented foods like kefir and sauerkraut provides additional gut support.
• If you experience severe digestive symptoms despite probiotic use, consult your healthcare provider as you may need additional intervention.
• It is essential to note that while probiotics are generally considered safe, patients with severe illnesses or those who place a high value on avoiding potential harms may reasonably select not to use probiotics 1.

From the Research

Medications to Protect the Gut While on Antibiotics

To protect the gut while on antibiotics, several medications have been studied for their effectiveness in preventing antibiotic-associated diarrhea and promoting gut health.

• Probiotics: Probiotics are living microorganisms that can affect the host in a beneficial manner 2, 3, 4, 5. They can influence intestinal physiology either directly or indirectly through modulation of the endogenous ecosystem or immune system.
• Specific Probiotic Strains: Certain probiotic strains, such as Lactobacillus GG, Saccharomyces boulardii, and Bifidobacterium bifidum, have been shown to be effective in preventing antibiotic-associated diarrhea and promoting gut health 2, 3, 4, 5.
• High-Dose Probiotic Mix: A high-dose, multistrain probiotic mix, including Lactobacillus spp., Bifidobacterium spp., Bacillus coagulans, and Saccharomyces boulardii, has been demonstrated to be beneficial in preventing antibiotic-associated diarrhea in adults 5.
• Safety and Efficacy: The use of probiotics, including Saccharomyces boulardii CNCM I-745, has been shown to be safe and effective in preventing antibiotic-associated diarrhea, without altering the pharmacokinetics of antibiotics such as amoxicillin 4, 6.

Key Findings

• Probiotics can prevent antibiotic-associated diarrhea and promote gut health 2, 3, 4, 5.
• Specific probiotic strains, such as Lactobacillus GG and Saccharomyces boulardii, are effective in preventing antibiotic-associated diarrhea 2, 3, 4.
• High-dose probiotic mixes can be beneficial in preventing antibiotic-associated diarrhea in adults 5.
• Probiotics do not alter the pharmacokinetics of antibiotics such as amoxicillin 6.