From the Guidelines
When taking antibiotics, it is recommended to also take probiotics, specifically Saccharomyces boulardii, to reduce the risk of Clostridium difficile infection, as suggested by the AGA clinical practice guidelines 1. The use of probiotics in conjunction with antibiotics has been studied extensively, and the evidence suggests that certain strains, such as Saccharomyces boulardii, can be beneficial in preventing antibiotic-associated diarrhea and Clostridium difficile infection 1.
- The AGA recommends the use of Saccharomyces boulardii, or the 2-strain combination of Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R, or the 3-strain combination of Lactobacillus acidophilus, Lactobacillus delbrueckii subsp bulgaricus, and Bifidobacterium bifidum, or the 4-strain combination of Lactobacillus acidophilus, Lactobacillus delbrueckii subsp bulgaricus, Bifidobacterium bifidum, and Streptococcus salivarius subsp thermophilus, for the prevention of Clostridium difficile infection in adults and children on antibiotic treatment 1.
- The evidence for the use of probiotics in other conditions, such as irritable bowel syndrome, inflammatory bowel disease, and respiratory tract infections, is less clear, and further studies are needed to determine their effectiveness 1.
- It is essential to note that the quality of the evidence for the use of probiotics is generally low, and more research is needed to fully understand their benefits and risks 1.
- When taking probiotics with antibiotics, it is recommended to take them at least 2 hours apart to maximize their effectiveness, and to continue taking them during the entire antibiotic course and for 1-2 weeks afterward to help restore the gut microbiome 1.
From the Research
Antibiotics and Probiotics
- The use of probiotics in conjunction with antibiotics has been studied for its potential to reduce abdominal pain and inflammation in patients with acute uncomplicated diverticulitis 2.
- A study found that a mix of three probiotic strains (Bifidobacterium lactis LA 304, Lactobacillus salivarius LA 302, and Lactobacillus acidophilus LA 201) in combination with standard antibiotic therapy reduced abdominal pain and inflammation significantly more than antibiotic treatment used alone 2.
- However, another study found that a probiotic yogurt did not have a significant effect on the prevention of antibiotic-associated diarrhea in hospitalized patients 3.
- A review suggested that taking probiotics for the entire course of antibiotic treatment can help prevent diarrhea 4.
- Probiotics have also been studied for their potential to alter the gastrointestinal microbiota during antibiotic treatment for Clostridium difficile infection, with some studies suggesting that they may have a positive effect on the microbiome 5.
- However, a randomized clinical trial found that a daily oral probiotic combination of Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp lactis BB-12 did not significantly reduce antibiotic administration for all-cause infections in care home residents 6.
Key Findings
- Probiotics may have a positive effect on reducing abdominal pain and inflammation in patients with acute uncomplicated diverticulitis when used in conjunction with antibiotics 2.
- Probiotics may not have a significant effect on the prevention of antibiotic-associated diarrhea in hospitalized patients 3.
- Probiotics may have a positive effect on the gastrointestinal microbiota during antibiotic treatment for Clostridium difficile infection 5.
- Probiotics may not reduce antibiotic administration for all-cause infections in care home residents 6.
Probiotic Strains
- Bifidobacterium lactis LA 304, Lactobacillus salivarius LA 302, and Lactobacillus acidophilus LA 201 have been studied for their potential to reduce abdominal pain and inflammation in patients with acute uncomplicated diverticulitis 2.
- Lactobacillus acidophilus La-5, Bifidobacterium animalis subsp. lactis Bb-12, and Lactobacillus casei subsp. casei Lc-01 have been studied for their potential to prevent antibiotic-associated diarrhea in hospitalized patients 3.
- Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp lactis BB-12 have been studied for their potential to reduce antibiotic administration for all-cause infections in care home residents 6.