It has been found that approximately 20% of patients taking antibiotics in outpatient settings develop antibiotic-associated diarrhea (AAD). The disruption of the gastrointestinal flora that normally acts as a barrier to infection and aids in the digestion of carbohydrates is a common cause. Probiotics replenish the natural gastrointestinal flora with nonpathogenic organisms.

Probiotics are live microorganisms that may provide various health benefits when consumed in adequate amounts. Antibiotics, on the other hand, are drugs that are used to kill or inhibit the growth of bacteria that cause infections. When taking antibiotics, probiotics that contain Lactobacillus or Bifidobacterium strains, as they have been shown to help replenish beneficial bacteria in the gastrointestinal tract (stomach and intestines).

The beneficial effects are maximized with a high dose probiotic (≥ 5 billion CFUs per day), high-quality probiotic supplement from a reputable manufacturer. Specifically, strains of Lactobacillus acidophilus, Lactobacillus rhamnosus, Bifidobacterium bifidum, and Saccharomyces boulardii have been found to be particularly effective in reducing the risk of antibiotic-associated diarrhea and other systemic side effects associated with antibiotic use.

It is important not to take probiotics at the same time as antibiotics. The National Institutes of Health recommends waiting at least two hours before or after taking an antibiotic to take probiotic supplements.

Probiotics may be safe to use in immune compromised patients. But if you are immune compromised, before taking them, ask your physician if probiotics are safe and effective for your specific health condition and medications.

Here are some potential benefits and risks of probiotics during antibiotic treatment:


  1. Reducing the risk of antibiotic-associated diarrhea: Antibiotics can disrupt the balance of bacteria in the gut, leading to diarrhea. Probiotics may help restore this balance and reduce the risk of diarrhea.
  2. Boosting the immune system: Probiotics may enhance the immune system’s response to infections, potentially reducing the duration and severity of illness.
  3. Preventing overgrowth of harmful bacteria: Taking probiotics may prevent the overgrowth of harmful bacteria in the gut, which can cause infections.
  4. Improving digestion: Probiotics may improve digestion and reduce digestive symptoms such as bloating, gas, and constipation.


  1. Interference with antibiotic effectiveness: Some probiotics may interact with antibiotics, potentially reducing their effectiveness.
  2. Infection risk: In rare cases, probiotics can cause infections, especially in people with weakened immune systems or those with a central venous catheter.
  3. Allergic reactions: Some people may be allergic to probiotics, leading to symptoms such as hives, itching, and swelling.
  4. Not all probiotics are gluten-free (although most are) and some may contain dairy (an issue if you’re also sensitive to the lactose and/or casein found in dairy products).
  5. Digestive symptoms: In some people, probiotics may cause digestive symptoms such as bloating, gas, and diarrhea.