From the Guidelines
The optimal timing for consuming probiotic-rich foods while taking antibiotics is at least 2-3 hours before or after your antibiotic dose. This separation is crucial because antibiotics don't distinguish between harmful bacteria causing your infection and beneficial bacteria in probiotics, potentially killing both if taken simultaneously 1. When taking common antibiotics like amoxicillin, ciprofloxacin, or doxycycline, maintain this time gap consistently throughout your treatment course. Probiotic-rich options include yogurt with live cultures, kefir, sauerkraut, kimchi, and kombucha.
Key Considerations
- The American Gastroenterological Association (AGA) suggests the use of certain strains and strain combinations of probiotics in the prevention of C difficile infection, including Saccharomyces boulardii, and specific combinations of Lactobacillus and Bifidobacterium species 1.
- The evidence for the effectiveness of probiotics in preventing antibiotic-associated diarrhea and C difficile infection is promising but has a low certainty due to the heterogeneity of the studies and the risk of bias 1.
- The optimal probiotic strains for use with antibiotics include S boulardii, Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum, among others, as they have shown potential in reducing the risk of C difficile infection and antibiotic-associated diarrhea 1.
Recommendations for Practice
- Continue consuming probiotic-rich foods for 1-2 weeks after completing your antibiotic course to help restore your gut microbiome.
- Be aware that the beneficial effect of probiotics is mainly seen in patients with a high risk of developing C difficile infection, and the decision to use probiotics should be individualized based on the patient's risk factors and values 1.
- Consider the potential for altered recovery of the gut microbiota after antibiotic use with probiotics, and the lack of standardization in probiotic formulations and study designs 1.
From the Research
Optimal Timing for Consuming Probiotic-Rich Foods with Antibiotics
- The optimal time to consume probiotic-rich foods while taking antibiotics is not clearly established, but studies suggest that taking probiotics with or shortly after antibiotics may be beneficial 2, 3.
- A study published in 2024 found that consuming probiotic yogurt four hours after antibiotic intake or concomitantly with antibiotics may help prevent antibiotic-associated diarrhea 2.
- Another study from 2010 recommends separating bacteria-derived probiotics from antibiotics by at least two hours 3.
- However, a 2011 study using an in vitro model of the human upper gastrointestinal tract found that survival of probiotic microbes was best when given with a meal or 30 minutes before a meal 4.
- A 2019 clinical trial found no significant difference in the prevention of antibiotic-associated diarrhea when probiotic yogurt was consumed within 48 hours of beginning antibiotic therapy and up to 5 days after stopping the antibiotic 5.
- A 2024 multicenter, randomized, double-blind, placebo-controlled trial found that a high-dose, multistrain probiotic mix administered from the first dose of antibiotics until 14 days after the last antibiotic dose was effective in preventing antibiotic-associated diarrhea 6.
Key Considerations
- The type and strain of probiotic, as well as the individual's health status and antibiotic regimen, may influence the optimal timing for consuming probiotic-rich foods 3, 6.
- More research is needed to determine the most effective timing for consuming probiotics with antibiotics and to establish practical guidelines for their use 2, 3, 6.