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Thread: Taking probiotics and antibiotics concurrently

  1. #21
    I keep seeing conflicting advice about whether probiotics are best taken on a full or empty stomach. Which is better?

  2. #22
    I just don't think there is a lot of information on probiotics at this point. They have just began to hit mainstream as far as popularity goes but many healthcare practitioners have been recommending yogurt for years to combat diarrhea and even yeast infections.

    There still seems to be conflict between many of these "natural" remedies and Western medicine. I definitely think they can be beneficial but I also believe there are several products out there that are essentially worthless.

    So do your research!

  3. #23
    This meta-analysis summarized more than 20 studies on probiotics effects on antibiotic diarrhea and c diff. It found only the probiotic S. boulardii was effective against c diff.

    I had trouble finding S. boulardii in most probiotic capsules being sold. Finally found it near me in a product called Florastor

    More good stuff here too.
    Last edited by quadfather; 03-01-2009 at 09:42 PM.

  4. #24

    when to take probiotics.

    I eat a lot of kefir. And since antibiotics kill bacteria, no matter good or bad, is it safe to say i should eat kefir after i eat antibiotics?


    Last edited by SCI-Nurse; 04-26-2009 at 12:57 PM. Reason: Removal of spam links

  5. #25
    I used to get diarrhea when taking certain antibiotics, and drugs like lamotil only helped sometimes. Now every time I'm on one I take one acidophilus tab with dinner daily and have not experienced this problem in years. Not sure how much is in each tab, but it's a brand available in the local grocery store and/or drugstore. I swear by the stuff.

  6. #26
    Senior Member canuck's Avatar
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    Mar 2003
    BC Canada
    I only get diarrhea with specific antibiotics so I just avoid being put on those when possible. Diarrhea is actually one of the first symptoms I get when I have a uti, once I get on antibiotics bowel return to normal. Never taken probiotics, never had to use I.V. antibiotics either.

  7. #27
    hmmm... i didn't know that.. i guess i'll have to try it.. i'll let you guys know what happens. : )

    Last edited by SCI-Nurse; 05-10-2009 at 06:49 PM. Reason: Removed spam link

  8. #28
    Senior Member Jeff B's Avatar
    Join Date
    Sep 2003
    Ontario, Canada
    In the first article that leschinsky linked to it states that:

    "During antibiotic therapy, taking probiotics as well keeps the intestinal flora in proper balance. They can be taken together, but not at the same time of day. In order for the probiotics to be the most effective, they should be taken at least two hours after each dose of antibiotic. When the treatment has been completed, double or triple the probiotic supplements for about ten days or two weeks. Probiotics should be taken with food or shortly after eating as food dilutes the stomach acids enough for them to survive their trip through to the intestines where they belong. "

    Both of these points make sense when you think about it. Regarding the first: You want to reintroduce good bacteria after you have killed off the bad with the antibiotics. Not before because then the antibiotics will also will off the probiotic bacteria as well. Antibiotics are not going to select what bacteria to leave behind.

    The science on this stuff is still pretty slim but in most cases probably can't hurt. I read that a main problem with the claims is that they market using huge sounding numbers like "1 billion colonies per dose!!!" but since your body can have up to 100 000 billion of bacteria in it it is unlikely to make as much of an impact as it sounds like. Sort of like throwing an ice cube in the bath and expecting it to cool it down immediately. They are still a cheap and easy thing that is worth a try before you have to go for a fecal transplant.

  9. #29
    Here are some results from a more recent meta-analyses, published January 2009 in Current Opinion in Gastroenterology, on probiotics and antibiotic-associated diarrhea:

    Antibiotic-associated Diarrhea. Antibiotic-associated diarrhea (AAD) occurs in about 5-25% of adult patients and 11-40% of children upon administration of broad-spectrum antibiotics. Clostridium difficile is a major agent, although diarrhea may be related to general changes in intestinal microflora. A systematic review[4] and a meta-analysis of RCTs[5] provided evidence of a moderate beneficial effect of Lactobacillus rhamnosus GG, Saccharomyces boulardii and a combination of Bifidobacterium lactis and Streptococcus thermophilus in preventing AAD. A recent Cochrane review of 10 RCTs carried out in 1015 treated and 971 control children reported a significant reduction in the incidence of AAD [Relative risk (RR) 0.49; 95% confidence interval (CI) 0.32-0.74], confirming the efficacy of LGG and S. boulardii. [6] The subgroup analyses provided evidence that probiotic dose may be responsible for the observed clinical and statistical heterogeneity of results. Interestingly, of the eight studies that provided dosage information, five studies in which children received 5-40 billion bacteria/yeast/day showed that probiotics had preventive effects (RR 0.35; 95% CI 0.25 to 0.47), whereas the combined results of three studies using less than 5 billion colony-forming unit (CFU) bacteria/yeast/day were not significant (RR 0.89; 95% CI 0.53 to 1.48, I2 = 61.4%). The number-needed-to-treat was between seven and 10. As suggested by the Cochrane review, more data are needed to consider the routine use of probiotics to prevent AAD in children started on large spectrum antibiotics. In particular, cost-benefit data are strongly needed.
    Two recent double-blind RCTs suggested that other strains were effective in preventing AAD. The first, conducted on 135 adults, showed that a drink containing Lactobacillus casei, Lactobacillus bulgaricus and S. thermophilus twice daily prevented AAD and diarrhea caused by C. difficile (number-needed-to-treat five and seven, respectively).[7] The second was a pediatric trial in which Lactobacillus rhamnosus (strains E/N, Oxy and Pen) reduced the risk of any diarrhea in children undergoing antimicrobial therapy for common infectious diseases.[8]
    The role of probiotics in C. difficile-associated diarrhea is still unclear. S. boulardii was found to be significantly effective in treating C. difficile diarrhea.[9] The benefit of probiotics in C. difficile diarrhea was mostly seen in adults and, particularly, in subgroups characterized by severe disease.[10] Despite the moderate evidence obtained in adults, the use of probotics to specifically treat or prevent C. difficile diarrhea has not been evaluated in a RCT in children. A recent meta-analysis showed that LGG and S. boulardii might be useful in treating or preventing recurrences of C. difficile diarrhea.[11] Nonetheless, the heterogeneity of the studies makes it difficult to draw definite conclusions.

    The link to the full article, which addresses the role of probiotics in diarrhea from other causes also, can be found below. Registration, which is free, is required to view the article (I think).

    Often the medical community is slow to embrace these complementary/natural healing type approaches, but they seem to be giving probiotics the two thumbs up. However some strains seem to be more effective than others. Sounds like LGG and S. boulardii are the two strains that seem to consistently end up with the best across the board results, so you may want to look for them if you find yourself shopping for a product.

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