Probiotics after antibiotic therapy: How helpful is their use?

The invention of antibiotics in the 19th century was a major milestone in modern medicine. Bacterial infections that had previously been fatal could be successfully treated. However, like all medications, antibiotics can also cause numerous side effects that should be kept in mind. In particular, the intestinal flora can become unbalanced when not only "bad" bacteria are attacked, but also "beneficial" intestinal bacteria. Is it therefore advisable to take probiotics, i.e. food supplements with selected intestinal bacterial cultures, after antibiotic therapy? We try to find an answer to this complex question.

Why probiotics after antibiotics?

In addition to harmful bacteria that can cause illness in acute cases, antibiotics can also damage beneficial intestinal bacteria if taken orally, e.g. in the form of tablets or juice. Depending on their mechanism of action, antibiotics attack the cell walls of certain bacteria, for example, and damage them permanently. While the clear advantage lies in fighting the infection, beneficial intestinal bacteria, which also have a cell wall, can be attacked and die in large numbers at the same time. Your body's own microbiome in the intestine, which is characterised by a variety of different bacteria, viruses and fungi, could thus be altered.

Probiotic food supplements contain selected intestinal bacteria, usually bifidobacteria and lactobacilli, which, when taken regularly, settle in your intestine and are supposed to restore a healthy balance to your microbiome. They do not under any circumstances replace therapy with an antibiotic or other medical therapies, but can only increase the number of beneficial, healthy bacteria in your intestine and thereby alleviate symptoms such as abdominal pain or diarrhoea. Numerous studies show that probiotics can moderately reduce the symptoms of antibiotic-induced diarrhoea, i.e. diarrhoea that occurs after taking antibiotics, especially in children and older people. (1,2)

Which strains are typically recommended?

Probiotics usually contain various selected strains of intestinal bacteria. The following strains are often mentioned for the alleviation of antibiotic-associated symptoms and have already been investigated in numerous studies:

Naturally, the effectiveness varies depending on the product, especially with regard to the number of strains and colony-forming units (CFUs), which represent the number of intestinal bacteria. Higher numbers of CFUs are considered helpful in this context, and a product with at least 5 billion CFUs is recommended. (1)

How do I take probiotics during antibiotic therapy?

In principle, there is nothing to prevent simultaneous intake. It can even be useful to start taking probiotics immediately and not wait until symptoms appear. It is advisable to leave some time between doses, e.g. 2-3 hours. It is also important to mention that it can often be useful to continue taking probiotics for several weeks after antibiotic therapy has ended.

Do I always take probiotics when I am prescribed antibiotics?

This article attempts to provide an easily understandable answer to a complex question and cannot, of course, formulate individual recommendations. Furthermore, there are many different antibiotics and very individual reactions of the body to them. It is simply not possible to make a general statement here. In addition, as always: taking a food supplement does not replace a balanced, healthy diet and there are no approved promises of healing for probiotic food supplements in Germany. Therefore, it is important that you inform yourself carefully and always consult your treating doctor for individual questions.

What do I need to consider?