Written by the Priceline Pharmacy Pacific Fair team. Reviewed by Jason Markey, BPharmSci, MPharm, Owner and Pharmacist.
General health information from a registered pharmacist. It doesn’t replace advice from your own pharmacist or doctor.
A probiotic can be worth considering when you start a course of antibiotics, especially if antibiotics have upset your stomach before. healthdirect says there is some evidence that taking probiotics during a course of antibiotics can reduce antibiotic-associated diarrhoea, and your doctor may suggest one. The benefit depends on the strain, though: not every probiotic on the shelf has been studied for this.
Probiotics also aren’t right for everyone. People with a weakened immune system shouldn’t take them. It’s a common question at our Pacific Fair prescription counter, so here’s what the evidence says, how to take one, and when diarrhoea on antibiotics needs a doctor.
Why do antibiotics cause diarrhoea?
Antibiotics kill the bacteria causing your infection, but they also kill some of the “good” bacteria that live in your gut. healthdirect lists diarrhoea, nausea and vomiting, and thrush among the common side effects of antibiotics.
The RACGP’s Handbook of Non-Drug Interventions (HANDI) notes that antibiotic-associated diarrhoea occurs in 2 to 15 per cent of people taking antibiotics. Some 20 to 30 per cent of those cases are thought to be caused by an infection with a bacterium called Clostridium difficile (often shortened to C. diff), which is one reason ongoing or severe diarrhoea needs a doctor.
Do probiotics prevent antibiotic-associated diarrhoea?
They may help some people. healthdirect says probiotic supplements can help restore your natural gut bacteria while you’re on antibiotics, and that there’s some evidence they reduce antibiotic-associated diarrhoea.
The important detail is the strain. As healthdirect puts it, not all probiotics are the same, and each strain provides different benefits. Among the strains it lists for preventing antibiotic-associated diarrhoea are:
- Saccharomyces boulardii
- Lactobacillus rhamnosus
When you compare products, check that the label names the strains it contains, rather than just saying “probiotic” or giving a total number of bacteria. healthdirect also notes that the amount needed as treatment is uncertain, so ask your pharmacist which product and dose suit you.
How should you take a probiotic with antibiotics?
- Take it during the course. The evidence healthdirect describes is for probiotics taken during a course of antibiotics.
- Follow the label for timing. Check the directions for how to space the probiotic from your antibiotic doses, and ask your pharmacist if you’re not sure how to fit them together.
- Keep taking your antibiotic as prescribed. healthdirect advises taking antibiotics for as long as you’re told to, even if you feel better. A probiotic is an extra, not a replacement for any dose.
- Expect a settling-in period. Bloating, wind and diarrhoea can happen, and healthdirect says these side effects are most common in the first week of taking probiotics.
- Check the storage instructions on the pack, and keep to them.
- Check your other supplements too. Some don’t mix well with certain antibiotics at the same time of day. Magnesium, for example, needs to be spaced from some antibiotics, and our magnesium guide explains the timing. Ask your pharmacist about anything else you take.
Who should avoid probiotics or ask first?
healthdirect says probiotics should not be taken by people who are immunocompromised (have a weak immune system). That includes people who:
- are very unwell
- are having chemotherapy
- have had an organ transplant
- are living with HIV
- take medicines that suppress the immune system
- have recently had surgery
If you or your child has a serious health condition, or you take regular medicines and aren’t sure whether a probiotic suits you, check with your doctor or pharmacist before you start.
Can you get probiotics from food?
Yes. healthdirect lists fermented foods and dairy such as yoghurt, kefir, sauerkraut, miso, pickles and kombucha as natural sources of probiotics. High-fibre foods such as fruit, vegetables, legumes, nuts and seeds provide prebiotics, which act as food for your good gut bacteria. Some products combine the two, and healthdirect notes these are called synbiotics.
These are a good everyday habit. If your goal is specifically to lower your chance of antibiotic-associated diarrhoea, healthdirect notes the amount and type of probiotic in supplements is controlled, which makes it easier to choose one of the strains studied for this.
How our pharmacists can help
When we dispense your antibiotic, we can explain which side effects to watch for, whether a probiotic is a sensible add-on for you, which strains to look for, and how to fit the doses around your antibiotic. You can send your script to us ahead of time and collect it when it suits you. Wondering about a drink while you’re on the course? See our guide to alcohol and antibiotics.
Antibiotics can also lead to thrush in the mouth or vagina, which healthdirect lists among their common side effects. If that happens during or after your course, talk to one of our pharmacists about treatment options, or about whether it’s time to see a GP.
Probiotics are part of our vitamins and supplements range, and a pharmacist can check one against your other medicines before you buy. You can also browse the probiotics range on priceline.com.au and ask our team in store.
When to see a pharmacist or GP
Keep taking your antibiotic unless your doctor tells you otherwise, and see a GP if you have:
- diarrhoea that is severe or keeps going
- blood or mucus in your poo
- a fever
- diarrhoea that wakes you at night, or unexplained weight loss
- signs of dehydration, such as feeling very tired, passing less urine, thirst or a dry mouth
- severe tummy pain
Tell the doctor you’ve recently taken antibiotics. Our in-store Help Medical GPs are one option. Older people and young children can become unwell quickly with diarrhoea, so don’t wait. For children, see our guide to gastro and keeping kids hydrated.
Oral rehydration solution from the pharmacy is a better choice than plain water for older people and children, and healthdirect doesn’t recommend sports drinks. Check with a pharmacist before taking anti-diarrhoea medicine, and don’t take it if you have a fever or blood in your poo.
Call 000 in an emergency. If someone has heavy bleeding from the bottom, signs of severe dehydration or collapses, call triple zero (000) or go to your nearest emergency department.
Sources
This article is general information only and isn’t a substitute for personal advice from your doctor or pharmacist. Always read the label and follow the directions for use. If symptoms persist or you’re worried, talk to your pharmacist or GP. In an emergency, call 000.
Talk to our pharmacists at Pacific Fair
Pop in, no appointment needed. We’re on the ground floor of Pacific Fair Shopping Centre, Broadbeach, open 7 days and until 9pm on Thursdays.