Taking Probiotics with Antibiotics or Anti-microbial Herbs

Taking Probiotics with Antibiotics or Anti-microbial Herbs


Should you take probiotics along with antibiotics? Hi. This is Dr. Ruscio, and a common question
or concern that my patients have is regarding probiotics and how to use them if they’re
taking antibiotics or herbal antimicrobials. Oftentimes what patients ask me is, “Shouldn’t
I wait to take a probiotic until after I have taken an antibiotic or an herbal antimicrobial
because the antibiotic or the herb will just kill the probiotic?” This is actually not correct, and there are
a few reasons for this. Now, probably the most clinically relevant
is that when we co-administer probiotics along with antibiotics or antimicrobial herbs, it
increases the success rate of treatment, and I will put up on the screen here and also
include a link to a systemic review with meta-analysis that has shown that the addition of a certain
probiotic, Saccharomyces boulardii, to the treatment of H. pylori significantly increases
the eradication rate of the H. pylori. This sort of finding has been found in other
infections or even things like SIBO also. Probiotic co-administration with treatment
tends to enhance treatment results. That is the most important reason why. Another question that patients often have
is, “After taking an antibiotic or antimicrobial, should I take a probiotic to reseed or to
repopulate the gut?” This is also wrong. Probiotics do not colonize you. They have a transient benefit. This has been shown in numerous studies, that
after taking a probiotic, weeks after taking a probiotic, any evidence of that probiotic
disappears from the stool. The reason for this is actually a good one. It’s because your microbiota, the world
of bacteria, fungus, and viruses and protozoa that inhabit your intestines in a healthy
way—that colony is resistant to re-colonization or colonization by new stuff coming in. So it’s good from the perspective of if
you swallow a bad bacteria, all of the current players in the gut want to prevent this guy
from settling in. So the gut is resistant to colonization by
stuff that we swallow. This includes probiotics. Now, probiotics do have a very beneficial
transient effect, so we certainly want to use probiotics. It’s not to say that we don’t want to
use them. But to maintain the benefit, you’ll probably
have to use them at least on and off to maintain a long-term benefit from a probiotic. It is possible that after a short course of
probiotic you may fix the underlying problem and you may not need it in the long term,
but the probiotic will not colonize you. These are some important things for people
to keep in mind, that taking a probiotic with antimicrobial or antibiotic treatment will
likely enhance the results as long as your clinician knows what probiotics to use with
what infections, and that probiotics don’t re-colonize you because your microbiota is
resistant to colonization from outside stuff, if you will. So, remember, if you are treating an infection,
probiotics may have a nice benefit used synergistically, and probiotics, again, do not re-colonize
you, and so you don’t have to worry about reseeding or repopulating after antimicrobial
or antibiotic therapy. It’s still a great idea to use probiotics,
but just understand that the probiotics are not going to colonize you or reseed or repopulate.

7 Replies to “Taking Probiotics with Antibiotics or Anti-microbial Herbs”

  1. I also see your saying there is no colonization? So do the probiotics just enhance the gut microbiota already existing?
    Is it ok to have fermented food daily? Does it hurt to be exposed to probiotics everyday?

  2. and my last question is,
    do the probiotics ie. like Bacillus coagulans, S. Boulardii, Polyphenois…..

    they do not exist in the GI? and so they just kind of come in… do there thing and leave? right?

    is lactic or citric acid the only types of antibiotics? or is there also another process in the antimicrobial elimination that is unique with herbs like oregeno and goldenseal?

    Please please educate me

  3. If the existing colonized bacteria that prevent new bugs from taking hold are decimated thru the use of antibiotics, what is preventing new probiotic strains (taken with/after the antibiotics) from colonizing in their place?

  4. that 'colony' is resistent to new things coming in coz already in biofilm…it dosent matter..can be healthy symbiosis or dysbiosis or sibo, whatever the stupid names are…but if you already created a dysbiosis is practically the same thing…you can beat it easily and is resistant to new stuff coming in

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