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Should I Take Antibiotics with Probiotics?

Does it make sense to supplement with beneficial bacteria when you're taking antibacterial drugs or is it a waste of time and money? Nutrition Diva explains how probiotics and antibiotics work together. 

By
Monica Reinagel, MS, LD/N, CNS
4-minute read
Episode #246

...Taking probiotics during antibiotic therapy significantly reduces the number of side effects. But that doesn't mean that everyone needs to take probiotics.

Nutrition Diva's Recommendations for Probiotic Therapy

If you're healthy: As a general rule, I don't think healthy people need to take probiotic supplements. They're not cheap, for one thing.  And I think you can accomplish the same goal by enjoying probiotic foods on a regular basis. A word of caution: If yogurt is your preferred source of friendly bacteria, be sure to choose plain yogurt and add your own fruit. Most fruit-flavored yogurt contains a shocking amount of sugar

When taking antibiotics:  Whenever you have to take an antibiotic, it's a good idea to ramp up your intake of cultured and fermented foods to compensate for the effects of the drug.  But only about 1 in 3 people experience side effects with antibiotics so you don't necessarily need a probiotic supplement - especially if you're only taking antibiotics for a week or so. 

When taking a lot of of antibiotics: Side effects are more common with extended or repeated courses of antibiotics. If you're dealing with a particularly difficult infection, the last thing you need is antibiotic-associated misery. Keep eating those probiotic foods but chat with your doctor about taking a probiotic supplement as well.

If you've had problems in the past:  People who have had trouble with with antibiotic-associated side effects such as diarrhea or yeast infections in the past may be more susceptible to these issues and might benefit from some extra probiotic insurance. Check with your doctor just to be sure. 

If you're being treated for h. pylori: Most stomach ulcers are caused by a bacteria called h. pylori, which is most effectively treated by antibiotics. With this particular bacteria, probiotics actually increase the effectiveness of the antibiotic therapy. So, if you're being treated for h. pylori, be sure to ask your doctor about probiotics.

Note: These recommendations are not intended to replace the advice of your health professional. 

Which Probiotic Should I Take?

In terms of which specific probiotic products or strains are most effective, the research reveals no clear winners.  However, most  studies use products that are prepared and tested specifically for research purposes. The consumer marketplace, meanwhile, is awash in probiotic products of various quality. People frequently ask me which product I recommend and I am always reluctant to choose a favorite because, frankly, I haven't evaluated and compared every product out there. Two products that have a good track record for both quality and efficacy are Culturelle and Florastor.  I'm sure there are others that are equally good - as well as some that are not as good.  Unfortunately, price is not always a reliable indication of quality. 

Thanks to Mickey for suggesting this week's topic. If you have a nutrition question you'd like me to address, you can send an email to nutrition@quickanddirtytips.com or you can post it on the Nutrition Diva Facebook page, which is where Mickey reached me. There's always lots going on there. Also be sure to sign up for my free weekly newsletter, for more tips, recipes, and answers to your questions.

References

Lynne V McFarland PhD. Meta-Analysis of Probiotics for the Prevention of Antibiotic Associated Diarrhea and the Treatment of Clostridium difficile Disease. The American Journal of Gastroenterology (2006) 101, 812–822.

Susanne Hempel, PhD; Sydne J. Newberry, PhD; et al. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea A Systematic Review and Meta-analysis. JAMA. 2012;307(18):1959-1969.

Image courtesy of Shutterstock.

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About the Author

Monica Reinagel, MS, LD/N, CNS

Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes' most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation's leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show. 

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