How to Stay Healthy While Taking Antibiotics

Sometimes antibiotics are the only line of defence against bacterial infection. They work either by killing infection-causing bacteria or by preventing them from reproducing, depending on the antibiotic class. Your healthcare provider typically prescribes antibiotics only when they are clearly needed and when the benefits outweigh the potential risks.

While most antibiotics target a specific type of infection, others are broad-spectrum. These are often used when the cause is unclear or when there is no precise treatment for that particular infection.

The problem is that antibiotics-especially broad-spectrum antibiotics-are known to wipe out even important, harmless bacteria that live in the body, such as those in the gut microbiome. This upsets the balance in the digestive tract. As a result, you might experience various unwanted symptoms, such as:

• Diarrhoea
• Nausea
• Loss of appetite
• Indigestion
• Bloating
• Abdominal pain

If these symptoms are severe, if you notice blood in your stool, or if you develop a high fever or signs of dehydration, you should seek medical care promptly.

Healthcare professionals often recommend adding a probiotic diet, supplements, or both to your antibiotic regimen. Here is why.

What are probiotics and why do people take them with antibiotics?

As mentioned earlier, antibiotics are vital for fighting bacterial diseases in the body, but they are often harsh on the digestive tract, as shown by the symptoms above. Sometimes the gut does not return to normal, or it takes too long to do so, even after you have finished your antibiotic course.

Fortunately, even while taking antibiotics, you have a few options that may help restore your gut ecosystem and overall health. One option is probiotics.

In simple terms, probiotics are "friendly" bacteria that live in the gut and are linked to optimal body function. Probiotic supplements contain billions of these helpful microorganisms, which can help maintain or restore balance in the digestive system.

These beneficial bacteria may counteract some negative effects of antibiotics by replacing bacteria that have been lost. They can help restore the normal balance of important bacterial communities in the body. Examples of such probiotics include strains of Lactobacillus, Bifidobacteria, and Saccharomyces (a beneficial yeast).

Probiotics, whether as foods or supplements, may be taken during or after an antibiotic regimen. However, people who are seriously ill, immunocompromised, pregnant, or living with chronic health conditions should check with a healthcare professional before starting probiotic supplements.

Probiotics vs prebiotics

In a nutshell, prebiotics are food for the beneficial bacteria in the gut microbiome (probiotics). Like any other organism, bacteria need fuel-this is what prebiotics provide. Eating prebiotics either before or after taking an antibiotic can help restore gut balance. Some foods and ingredients contain prebiotics, including:

• Bananas
• Garlic
• Onions
• Chicory root
• Garlic
• Jerusalem artichokes

In addition, some manufactured foods are fortified with prebiotics, including:

• Cereals
• Yoghurt
• Bread
• Infant formula

When checking food labels for prebiotics, look out for terms such as:

• Galactooligosaccharides (GOS)
• Chicory fibre
• Fructooligosaccharides (FOS)
• Inulin
• Oligofructose (OF)

Caveat: most prebiotics, as you may have noticed, are dietary fibres. Consuming them in large quantities may cause bloating.

Probiotics that pair well with antibiotics

Although some foods contain probiotics and/or prebiotics, they are often present only in small amounts and may not be enough to relieve antibiotic-related symptoms, especially when symptoms are more pronounced. However, clinicians do recommend combining probiotic supplements with an appropriate diet.

When should you take probiotics?

It is common to wonder whether probiotics should be taken alongside antibiotics or after treatment is finished. Either approach may be appropriate, depending on your preferences and how urgently you want to support your gut microbiome. However, experts strongly advise against taking them at exactly the same time, because antibiotics might also destroy the bacteria you are trying to introduce through probiotics.

It is generally better to take probiotics a few hours after an antibiotic dose, or a few hours before. For example, if your antibiotic doses are in the morning and evening, you may want to take probiotic supplements in the middle of the day. A common rule of thumb is to take them between daily antibiotic doses. This timing gives the antibiotic time to work in the gut as much as possible before you introduce beneficial bacteria.

In addition, dietitians and clinicians often recommend continuing probiotics and prebiotics for at least 1-2 weeks after the antibiotic regimen is complete. This is because the effects of medicines on the gut microbiota can continue for a short time after the course of treatment ends.

Remember, the main reason it is recommended not to take probiotics and antibiotics at the same time is that antibiotics may reduce the effectiveness of probiotics. Other than that, there is no chemical interaction between the two.

Probiotic supplements generally have an excellent safety profile. Rare and minor side effects have been reported, including diarrhoea, constipation, thirst, bloating, flatulence, rash, abdominal pain, vomiting, and nausea. If you experience severe or unusual symptoms after starting a probiotic, stop taking it and contact a healthcare professional.

Which antibiotic-related symptoms can probiotics help with?

Many symptoms associated with antibiotic use may improve or stop entirely with the introduction of probiotics, but probiotics are not a panacea. Nevertheless, many people find symptoms more manageable with probiotics than without them.

That said, probiotics may be used to help prevent antibiotic-related symptoms or to help relieve symptoms once they occur. If you have experienced these effects before, or you want to reduce the risk of them occurring, you may wish to include probiotics as part of your therapy. At the same time, do not stop or change an antibiotic without first checking with the clinician who prescribed it.

If you are already experiencing adverse effects and want to settle them by helping restore normal digestive function, probiotics may still be a useful option. Problems that probiotics may help with include:

1. Antibiotic-associated diarrhoea (AAD)

One of the most common unwanted outcomes of antibiotic regimens is diarrhoea, affecting about 1 in 3 people taking antibiotics. As mentioned earlier, antibiotics can destroy both "good" and "bad" bacteria in the body. Beneficial bacteria in the intestines play a crucial role in maintaining health, and a reduction in these bacteria may lead to a range of unwanted effects.

For example, gut bacteria help with water absorption and maintaining firm stools. They also help keep opportunistic bacteria such as Clostridium difficile (C. diff) in check. When the gut microbiome is disrupted, C. diff can multiply, causing infection and producing toxins that may lead to inflammation and diarrhoea.

Probiotics may help by replenishing beneficial gut bacteria and supporting normal bowel function. One research review of 17 studies found that probiotics could significantly reduce the risk of developing AAD.

2. Stomach pain

As with diarrhoea, stomach pain may result from antibiotic-related disruption of gut flora. Inflammation linked to C. diff overgrowth may present as painful abdominal cramps. In mild cases, symptoms may last up to 2 weeks after treatment; in severe cases, they may continue for weeks after the medication is finished.

To help reduce these unwanted effects, you may wish to take probiotics alongside your antibiotic regimen and include the complementary foods mentioned earlier.

What can you do if you are experiencing stomach pain?

• Try applying a hot pack, as you would for cramps
  • This can be a hot water bottle or a heating pad.
  • This can help the stomach relax.
• Warm up some chamomile tea
  • This herbal remedy may help ease inflammation.
  • It may soothe the stomach.
• Drink rice water
  • This may create a soothing barrier in the stomach lining.
• Warm up some ginger tea
  • This may help with nausea and relax the muscles in the intestinal tract.
  • It may also be effective for stomach cramps.

These home remedies, alongside probiotics, may help with mild stomach pain. Home remedies can ease mild discomfort, but severe or worsening pain, fever, vomiting, or an inability to keep fluids down requires prompt medical evaluation.

3. Nausea

Medicines such as erythromycin and aspirin can cause nausea. Other drugs (such as ibuprofen, a non-steroidal anti-inflammatory drug, and nifedipine, a blood pressure medicine) may also trigger vomiting. In some cases, nausea reflects how a medicine works; for example, pain medicines such as Vicodin and Percocet interact with the part of the brain responsible for nausea and vomiting.

With antibiotics, however, nausea is often linked more directly to digestive issues. This is common among older people, whose digestive systems may retain the medicine for longer before fully absorbing it through the digestive tract.

Experts recommend taking probiotics with antibiotics to help restore the gut flora ecosystem. This can help the gut recover during antibiotic treatment. If nausea is intense or prevents you from taking your medicines as prescribed, call your healthcare provider; an adjustment in timing, dose, or medication may be needed.

4. Bloating

Bloating can also be linked to disruption of the normal gut microbiome balance. Antibiotics may lead to overgrowth of the wrong bacteria in the small intestine. As a result, you may experience bloating even long after you have finished your antibiotic course.

This type of infection may require probiotics to help re-establish a normal bacterial balance in the gut, or a change in medication.

Remember, probiotics are not a one-size-fits-all solution, but they may go a long way towards restoring healthy digestive function. If symptoms do not improve even after you have started supplements, you should consider discussing this with your doctor.

How to take probiotics correctly

As you may already know, when combining probiotics with antibiotics, you should take probiotics a few hours after taking the antibiotic to increase the chance that the probiotics will survive. However, antibiotics are not the only threat to these beneficial bacteria. Probiotics also need to survive stomach acid long enough to reach the lower parts of the gut.

Why is this an issue? Stomach acidity is influenced by several factors, including whether your stomach is empty or full. During fasting (when you are extremely hungry), gastric pH will most likely range between 1.7 and 2, which is very acidic.

In contrast, pH typically rises after a meal, which makes the gut less acidic. However, food intake also triggers the release of digestive enzymes into the stomach, and these enzymes may damage probiotics as well.

In addition, taking probiotics alongside a heavy meal may slow digestion. This can delay the movement of beneficial bacteria to the lower parts of the gastrointestinal (GI) tract. A longer transit time also means probiotics are exposed to stomach acid and digestive enzymes for longer.

So, when deciding whether to take probiotics on an empty stomach, it is usually best to have a small amount of food in your stomach, rather than a heavy meal. Another way to decide on timing is to consider why you are taking probiotics in the first place.

If you are trying to manage digestive issues (such as bloating and diarrhoea), you may want to take probiotics with each meal. If you are trying to improve sleep quality, you may want to take them before bed. Experts are beginning to identify links between probiotics and the sleep-wake cycle.

Your schedule also matters. Early risers may benefit more from taking probiotics in the morning. The same principle applies for night owls.

Also remember to complement probiotics with prebiotic fibres (such as onions, garlic, leeks, jicama, and dandelion greens) or other prebiotic foods such as yoghurt and fermented grains whenever possible. These can help create a supportive environment for beneficial bacteria to multiply.

Probiotics and prebiotics timing

The best cheap probiotics we recommend

Which probiotic is best to take with commonly prescribed antibiotics such as Amoxil, Avelox, Cipro, Chloromycetin, or Zithromax?

After focusing on affordability, here are three probiotics that we believe are not only helpful for antibiotic prophylaxis, but also affordable and easy to fit into a daily schedule. These are examples of products commonly used for gut support; they are not the only acceptable choices.

1. Yogut:

Yogut® capsules may help your body to normalise gut organisms and flora. As mentioned in this article, some antibiotics can cause a range of side effects, including diarrhoea; Yogut® capsules may be useful in managing these effects.

2. PrePro:

PrePro® capsules are commonly used for bowel problems. They are therefore suitable for people struggling with IBS, constipation, diarrhoea, and other common problems associated with taking antibiotics. They may also be beneficial for eczema.

3. Pro-Wel

Pro-Wel® sachet is used for gastric ulcers, among other gastrointestinal conditions. It has an active probiotic composite and contains multiple bacterial strains, which are important for balancing the gut mucosa.

These probiotics may be helpful for some people, but they are not right for everyone. Always talk to your doctor, pharmacist, or another qualified healthcare professional before starting a new probiotic, especially if you are pregnant, older, taking multiple medicines, or living with a chronic health condition.