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Probiotics and Antibiotics- The Perfect Pair

Infection strikes

Sometimes we get sick with an infection and our doctor may prescribe an antibiotic. We might be hesitant about taking it because on the one hand we want to get rid of the infection, but on the other hand we don't want to deal with uncomfortable side effects. If you are taking an antibiotic there is a chance you will experience diarrhoea or other side effects like nausea, bloating, abdominal pain or vaginal yeast infections (in women).[i][ii]

Your Gut's Best Friends 

Our gut is home to trillions of microbes which work with our immune system to protect us from disease. These microbes are collectively known as the gastrointestinal microbiome.

Our gut microbes fill up space in our intestines acting as a barrier to keep unwanted pathogens out. Our gut microbiota primes our immune system and teaches it when to launch an attack and when to resist. A healthy gut microbiome is all about diversity - there must be many different types of microbes living together.[iii]

Antibiotics don't discriminate

Antibiotics can't tell the difference between the bacteria responsible for an infection and your body's own microbiome. So, as they go in annihilating the bacteria causing your infection they also wipe out valuable gut microbes. This creates a loss of diversity in your gut microbiome leaving it open to bacterial overgrowth. The use of antibiotics has been shown to cause long-term and in sometimes permanent damage to your gut microbiome.[iv] They are more likely to cause side effects if you take them repeatedly or if you already have a weakened immune system.

Children who take antibiotics are at an increased risk of developing allergies, asthma, autoimmune conditions[v] and obesity.[vi]

Side effects of antibiotics[ii]

  • Abdominal pain
  • Antibiotic associated diarrhoea (AAD)
  • Bloating
  • Fungal infections of the intestine and vagina[vii]
  • Indigestion
  • Loss of appetite
  • Nausea
  • Vomiting 

Guard your Gut... It's not all doom and gloom, there are steps you can take to preserve and restore your gut microbiome during and after a course of antibiotics.  If you are looking to reduce the side effects of antibiotics a probiotic supplement regime may help.

Why you should take probiotics 'with' antibiotics

Probiotics contain beneficial microbes that work to keep the bacterial communities within the gut in a balanced state. They maintain the gut environment and help to regulate the immune system.

Some people may say there is no point taking probiotics and antibiotics together because the antibiotics will kill all the probiotic bacteria. However, research actually shows that it's better to take probiotics ‘with’ antibiotics. They are the perfect companions because probiotics promote the restoration of gut microbial communities and thereby prevent side effects.[viii] [ix] Probiotics. also produce antibacterial substances and improve immune function and therefore may help antibiotics to work more effectively.[x]

Probiotics can help to reduce the side effects of:

  • Antibiotic Associated Diarrhoea (AAD): Taking probiotics with antibiotics helps to prevent and treat antibiotic-associated diarrhea.[xi] [xii] The majority of benefits seen in the research are based on Lactobacillus or Lactobacillus and Bifidobacterium combinations including: Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus plantarum, Lactobacillus bulgaricus, Bifidobacterium bifidum, Bifidobacterium breve and Bifidobacterium longum. [xii]
  • Clostridium difficile infection (C. diff): diff infections happen when your gut microbiome has been disrupted from antibiotics, allowing the C.diff bacteria to overgrow. C. diff infection can cause severe diarrhea and inflammation of the colon. The good news is that taking probiotics with antibiotics has been shown to prevent C. diff infections.[xiii] Lactobacillus acidophilus and Lactobacillus casei have shown to have the best preventative effects.
  • Fungal Infections (Candidiasis): The Candida yeast normally lives in our mouth, our gut and the vagina in women, without causing any problems.However, broad-spectrum antibiotics are known to cause dysbiosis and pre-dispose to a candida overgrowth.[xiv]  Researchers have found that Lactobacillus species have antifungal effects against candida through the production of lactic acid, and other antimicrobial substances that directly inhibit the growth of Candida.14 The Lactobacillus species shown to have these effects include Lactobacillus acidophilus, Lactobacillus fermentum, Lactobacillus paracasei, Lactobacillus reuteri, and Lactobacillus rhamnosus.[xv] [xvi] [xvii] This is an area of growing research and so far has been promising.

How do I know what probiotic to choose?

Taking a multi-species, multi-strain probiotic is a good place to start. Ideally, your probiotic should contain a variety of species as they each have unique functions and beneficial relationships with each other that enhance their effect in the gut and improve their survival. The combination of both Lactobacillus and Bifidobacterium species provide benefits for both the small and large intestine.

Look for an evidence-based, scientifically formulated probiotic because it is good re-assurance that your probiotic will do what it promises to.

Probiotics are usually measured in colony-forming units (CFUs). Higher CFU counts does not always improve the product’s effectiveness.The minimum dose for a number of strains is 1 billion (10) CFU/day, therefore it's recommended that each species of probiotic contains at least (10) CFU/day. To reduce the side-effects from antibiotics, your probiotic should provide 50-100 billion total CFU per day.

Using a probiotic that offers flexible dosing, gives you with an option to split your doses over the day and makes it versatile enough to use for the whole family.

Tips for taking your probiotic with your antibiotic

  • Make sure you wait 2 hours after taking your antibiotic before you take your probiotic, so that the probiotic bacteria are able to reach the gut alive.
  • Take your probiotics every day during the course of antibiotics for best results.
  • If you have already finished a course of antibiotics, you can still reap the benefits of using a probiotic to help your microbiome to recover.
  • Remember to eat a fibre rich diet to help to feed your microbiome.

MultiBiotic

MultiBiotic™ is a scientifically formulated, multi-strain probiotic that is being clinically researched in Australia. It contains a balanced combination of Lactobacilli and Bifidobacterium species to target both the small and large bowel, supporting the natural balance of bacteria in the gut.  MultiBiotic not only helps to restore the gut microbial balance after antibiotic use, but also supports immune function and can help manage the symptoms of medically diagnosed Irritable bowel Syndrome (IBS). It allows for flexible dosing making it the perfect partner to your antibiotic regime.

 

Click here to checkout MultiBiotic, our probiotic mood support.

This article does not a represent a product description, nor a summary of therapeutic indications of any of Medlab’s products. If you are interested in a Medlab product, please read the product label or the product information published in the product section shop.medlab.co prior to purchase. If you are unsure whether a product is right for you, please talk to a healthcare professional.

References

  1. [i] Mohsen S, Dickinson JA, Somayaji R. Update on the adverse effects of antimicrobial therapies in community practice. Can Fam Physician. 2020;66(9):651-659.
  2. [ii] Antibiotics, explained. NPS MedicineWise. https://www.nps.org.au/consumers/antibiotics-explained#what-are-the-side-effects-of-antibiotics? Reviewed 2019. Accessed March 19, 2021.
  3. [iii] Belkaid Y, Hand TW. Role of the microbiota in immunity and inflammation.Cell. 2014;157(1):121-141. doi:10.1016/j.cell.2014.03.011
  4. [iv] Jernberg C, Löfmark S, Edlund C, Jansson JK. Long-term ecological impacts of antibiotic administration on the human intestinal microbiota [published correction appears in ISME J. 2013 Feb;7(2):456].ISME J. 2007;1(1):56-66. doi:10.1038/ismej.2007.3
  5. [v] McDonnell L, Gilkes A, Ashworth M, et al. Association between antibiotics and gut microbiome dysbiosis in children: systematic review and meta-analysis. Gut Microbes. 2021;13(1):1-18. doi:10.1080/19490976.2020.1870402
  6. [vi] Del Fiol FS, Balcão VM, Barberato-Fillho S, Lopes LC, Bergamaschi CC. Obesity: A New Adverse Effect of Antibiotics?. Front Pharmacol. 2018;9:1408. Published 2018 Dec 3. doi:10.3389/fphar.2018.01408
  7. [vii] Sobel JD. Vulvovaginal candidosis. 2007;369(9577):1961–1971. doi:10.1016/s0140-6736(07)60917-9 
  8. [viii] Linares DM, Ross P, Stanton C. Beneficial Microbes: The pharmacy in the gut.Bioengineered. 2016;7(1):11-20. doi:10.1080/21655979.2015.1126015
  9. [ix] Wang F, Feng J, Chen P, et al. Probiotics in Helicobacter pylori eradication therapy: Systematic review and network meta-analysis.Clin Res Hepatol Gastroenterol. 2017;41(4):466-475. doi:10.1016/j.clinre.2017.04.004
  10. [x] Reid G. Probiotics to prevent the need for, and augment the use of, antibiotics.Can J Infect Dis Med Microbiol. 2006;17(5):291-295. doi:10.1155/2006/934626
  11. [xi] Cai J, Zhao C, Du Y, Zhang Y, Zhao M, Zhao Q. Comparative efficacy and tolerability of probiotics for antibiotic-associated diarrhea: Systematic review with network meta-analysis. United European Gastroenterol J. 2018;6(2):169-180. doi:10.1177/2050640617736987
  12. [xii] Hempel S, Newberry SJ, Maher AR, et al. Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis.JAMA. 2012;307(18):1959-1969. doi:10.1001/jama.2012.3507
  13. [xiii] Ma Y, Yang JY, Peng X, Xiao KY, Xu Q, Wang C. Which probiotic has the best effect on preventing Clostridium difficile-associated diarrhea? A systematic review and network meta-analysis.J Dig Dis. 2020;21(2):69-80. doi:10.1111/1751-2980.12839
  14. [xiv] Matsubara VH, Bandara HM, Mayer MP, Samaranayake LP. Probiotics as Antifungals in Mucosal Candidiasis. Clin Infect Dis. 2016;62(9):1143-1153. doi:10.1093/cid/ciw038
  15. [xv] Rossoni RD, de Barros PP, de Alvarenga JA, Ribeiro FC, Velloso MDS, Fuchs BB, et.al. Antifungal activity of clinical Lactobacillus strains against Candida albicans biofilms: identification of potential probiotic candidates to prevent oral candidiasis. Biofouling. 2018 Feb;34(2):212-225. doi: 10.1080/08927014.2018.1425402.
  16. [xvi] Murina F, Graziottin A, Vicariotto F, De Seta F. Can Lactobacillus fermentum LF10 and Lactobacillus acidophilus LA02 in a slow-release vaginal product be useful for prevention of recurrent vulvovaginal candidiasis?: A clinical study. J Clin Gastroenterol. 2014;48 Suppl 1:S102-S105. doi:10.1097/MCG.0000000000000225
  17. [xvii] Davar R, Nokhostin F, Eftekhar M, Sekhavat L, Bashiri Zadeh M, Shamsi F. Comparing the Recurrence of Vulvovaginal Candidiasis in Patients Undergoing Prophylactic Treatment with Probiotic and Placebo During the 6 Months. Probiotics Antimicrob Proteins. 2016;8(3):130-133. doi:10.1007/s12602-016-9218-x
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