In Australia, around 30 million courses of antibiotics are prescribed every year, and while they’re an important resource for combating illness and infection, they can reduce the diversity of beneficial bacteria in the gut and negatively impact the health of our guts and overall wellness.
Probiotics are an exceptional tool for counteracting these negative effects, but it’s essential to understand when and how to use them to optimise their benefits.
The importance of a balanced gut microbiome
Our bodies host numerous thriving communities of microbial life, including bacteria, viruses, archaea and fungi. The most diverse and abundant community of microorganisms lives inside the gut and is known as the gut microbiome. These living microorganisms perform a range of important functions and can influence many different aspects of our health. It is now widely accepted that the influence of the gut microbiome extends far beyond our digestive tract, with effects on our immune system, skin health, bone health and more[1].
When the different types of microorganisms that make up the gut microbiome are well-balanced, our health is benefitted. With a healthy diet and lifestyle, the different types of microbes that live in the gut and their abundance generally remain stable over time. However, external influences such as antibiotics can disrupt its composition and create an environment that allows unfavourable microorganisms to grow. When these microorganisms become too dominant, the gut microbiome has the potential to negatively impact our health. It’s therefore to restore balance when it becomes disrupted.
What are common side effects of antibiotics?
A common consequence of antibiotics is antibiotic-associated diarrhoea (AAD). This highlights the incredibly important role that beneficial gut bacteria play in regulating our digestion. AAD is a sign that these beneficial bacteria have diminished, and non-beneficial bacteria have overgrown, leading to inflammation in the gut and diarrhoea[2]. In addition, recent research has associated depleted gut microbiome, as a result of antibiotic-use, with an increased risk of long-term conditions such as asthma, depression, and anxiety[3].
Can probiotics help with side effects of antibiotics?
Certain strains of probiotics have proven to support the balance of beneficial bacteria in the gut, and to significantly decrease the risk of antibiotic-associated diarrhoea[4].
As antibiotics reduce the population of beneficial bacteria in the gut, it can be important to restore balance by supplementing beneficial probiotic bacteria.
Should you take a probiotic before, during or after antibiotics?
The research[5],[6] tells us that certain strains of probiotics are:
- Effective when taken alongside a course of antibiotics
- Most useful for preventing antibiotic-associated diarrhoea, and
- Less effective when started after antibiotic-associated diarrhoea has already begun.
Should you take the probiotic capsule and antibiotic pill at exactly the same time?
Evidence indicates that taking probiotics alongside a course of antibiotics is beneficial, but the research doesn’t yet specify whether probiotics should be taken at the exact same time as the antibiotic. It is hypothesised that a two-hour window in between may help to preserve the activity of probiotics for greater effects. However, due to how the body digests, absorbs and distributes antibiotics around the body, it is possible that this two-hour window wouldn’t make a significant difference.
Should you keep taking probiotics after your course of antibiotics?
Probiotic supplements provide a number of benefits when taken alongside antibiotics. As well as preventing antibiotic-associated diarrhoea, they help to repair the gut and promote gut health, support the restoration of beneficial gut bacteria, and boost the immune system.
Probiotics can help to reduce inflammation in the gut and help to repair intestinal cells that may have been damaged by increased inflammation, stemming from antibiotic-use. Specific probiotic strains, such as Lactobacillus rhamnosus GG and Lactobacillus plantarum 6595, have been shown to improve the health of epithelial cells and promote healing by reducing inflammation[7],[8]. By improving the health of the cells that line the gut, probiotic bacteria can help to create an environment that supports the growth of beneficial microorganisms and restore balance to the gut microbiome.
Enhancing immune system function with immune-boosting probiotic strains
Enhancing immune system function is also an important aspect of antibiotic recovery and can help us to maintain health in the long term. Two specific probiotic strains, Lactobacillus paracasei 8700:2 and Lactobacillus plantarum HEAL9, have been shown to help enhance immune system function and reduce the number, duration and severity of common colds compared to placebo[9],[10]. Supplementing with targeted probiotic strains may help to keep you well in the winter months.
Activated Probiotics are clinically-trialled, condition-specific live bacteria supplements. Each probiotic product in the range is formulated with targeted strains to support a specific area of health such as antibiotic recovery digestion, immune system function, skin health, iron absorption, vaginal health and more.
Speak with a pharmacist at your local WholeLife Pharmacy and Healthfoods to discuss which product is right for you. Always read the label and follow directions for use.
References
[1] Australian Commission on Safety and Quality in Health Care (ACSQHC). AURA 2016: first Australian report on antimicrobial use and resistance in human health. Sydney: ACSQHC, 2016.
[2] Anwar, H., Irfan, S., Hussain, G., Naeem Faisal, M., Muzaffar, H., Mustafa, I., Mukhtar, I., Malik, S., & Irfan Ullah, M. (2020). Gut Microbiome: A New Organ System in Body. In Parasitology and Microbiology Research (pp. 1–20). IntechOpen.
[3] Hickson M. Probiotics in the prevention of antibiotic-associated diarrhoea and Clostridium difficile infection. Therap Adv Gastroenterol. 2011 May;4(3):185-97.
[4] Queen J, Zhang J, Sears CL. Oral antibiotic use and chronic disease: long-term health impact beyond antimicrobial resistance and Clostridioides difficile. Gut Microbes [Internet]. 2020;11(4):1092–103.
[5] Szajewska H, Kołodziej M. Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Aliment Pharmacol Ther [Internet]. 2015 Nov;42(10):1149–57.
[6] Szajewska H, Kołodziej M. Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Aliment Pharmacol Ther [Internet]. 2015 Nov;42(10):1149–57.
[7] Shen NT, Maw A, Tmanova LL, Pino A, Ancy K, Crawford C V., et al. Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis. Gastroenterology [Internet]. 2017;152(8):1889-1900.e9.
[8] Segers ME, Lebeer S. Towards a better understanding of Lactobacillus rhamnosus GG – host interactions. Microb Cell Fact [Internet]. 2014;13(Suppl 1):S7
[9] Rayes N, Hansen S, Seehofer D, Müller AR, Serke S, Bengmark S, et al. Early enteral supply of fiber and Lactobacilli versus conventional nutrition: a controlled trial in patients with major abdominal surgery. Nutrition [Internet]. 2002 Jul;18(7–8):609–15.
[10] Busch R, Gruenwald J, Dudek S. Randomized, double blind and placebo controlled study using a combination of two probiotic Lactobacilli to alleviate symptoms and frequency of common cold. Food Nutr Sci [Internet]. 2013;04(11):13–20.
[11] Berggren A, Lazou Ahrén I, Larsson N, Önning G. Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections. Eur J Nutr [Internet]. 2011 Apr 28;50(3):203–10.
