Should I take Probiotics after being on Antibiotics?

Author: Gemma Shelton   Date Posted:4 May 2016 

There is no doubt that antibiotics are lifesaving and have their place in certain circumstances. The problem arises when antibiotics are prescribed incorrectly, because not only do they work to target the invading pathogen, they also indiscriminately kill off both the ‘bad’, as well as the ‘good’ microbiota. This often creates upset in our gut microbiome and rather than acting as ‘lifesavers’, over and prolonged use of antibiotics can be life changing.

Alterations to our diverse gut microbiome may present as short-term gut symptoms like diarrhoea, constipation and/or bloating; as well as longer-term health consequences including the emergence of antibiotic-resistance strains and an increased prevalence of certain diseases.


It only takes one prescription!

It was previously believed our gut microbiota normalises after a couple of weeks post antibiotic therapy, however recent evidence suggests some antibiotics can have long-lasting impact.

Overall antibiotic therapy was associated with:

  • A reduction in microbiome diversity: may lead to health effects including antibiotic-associated diarrhoea (AAD), as well as increased risk of ectopic diseases and inflammatory bowel disease.
  • An increase in antibiotic-resistance strains: may lead to the occurrence and threat of ‘superbugs’ which may be associated with treatment failure and increased healthcare costs.
  • A decrease in short chain fatty acid (SCFA) production: an important source of energy for the cells of the colon to help reduce inflammation and oxidative stress.


When antibiotics are unavoidable…

If you find yourself in a situation where antibiotics are necessary, there are a couple of things you may like to consider to help minimise destruction and quickly rebuild your gut microbiome community. You may have previously taken a probiotic after antibiotic treatment, but have you considered taking a probiotic during antibiotic therapy?

A significant amount of research has ‘touted’ the effectiveness of a specific probiotic strain known as Saccharomyces boulardii (SB) during antibiotic treatment.


What is SB?

When microbiologist, Henri Boulard was visiting IndoChina, he noticed people drinking a special tea did not develop certain digestive disturbances. This tea was made from the outer skin of mangosteen and lychee and when he isolated the agent responsible, he discovered a special strain of yeast. Mr Boulard named this yeast after himself, christening it- ‘Saccharomyces boulardii'.

Don’t let the term ‘yeast’ send you running....  SB is a different species to Candida albicans (known to cause thrush). Unlike Candida, SB works to occupy the lining of the gut and ‘crowd out’ harmful microorganisms to ensure opportunistic species like Candida do not overgrow. So during antibiotic use, SB acts as your own personal body-guard by occupying the space where the goodies once inhabited to stop the growth of unwanted guests.  



What makes SB so special?

Unlike many probiotics, SB is naturally resistant to the effects of antibiotics and therefore can be taken alongside; it can also withstand our body temperature, gastric acid and bile to survive passage to the colon where it is utilised. The added bonus is that it is stable at room temperature and thereby does not need to be kept in the fridge.

The friendly yeast has been extensively studied for its use in preventing diarrhoea and diarrhoea predominate irritable bowel syndrome, and works to encourage balance in the gut by:

  • Interfering with pathogen colonisation.
  • Modulating the immune response.
  • Stabilising gut barrier function.
  • Restoring the normal levels of SCFAs.


So when do I take SB?

During and after antibiotic treatment (for at least one week or so post antibiotic therapy depending on the integrity of your digestive system). SB does not colonise in the gut, it rather occupies the gut wall temporarily. SB concentrations are usually achieved within 3 days and after cessation of supplementation, SB is cleared within 3 to 5 days.

  • During antibiotics: Consider Probiotic SB and focus on adding certain types of fibre to your diet. The addition of psyllium has shown to increase SB levels by 22%.
  • After antibiotics: Consider co-administration of Probiotic SB with a multi-strain probiotic. This will allow for beneficial strains of bacteria to recolonise your gut microbiome.

And don’t forget to continue to nourish your gut microbiome with pre and probiotic foods including fermented foods and lots of fibre-rich fruit & veg to help keep your gut microbiome ‘in check’.


Written by Gemma Shelton, Naturopath

Gemma BHSc (Naturopathy); BA (Public Communication & International Studies); is a qualified naturopath and believes in the importance of a balanced lifestyle. She places emphasis on eating nutritious foods, without depriving yourself of the occasional treat. Gemma spent some time living in Japan where she was immersed in traditional diet and kampo medicine (Japanese herbal medicine), and an interest in natural medicine was sparked. She holds a degree in Health Science majoring in Naturopathy, and previous experience consulting in nutrition communications. Gemma loves the sunshine, good quality chocolate and herbal teas.