Can I take probiotics with antibiotics?

Joanna Scott-Lutyens BA (Hons) DipION

Yes, you can take probiotics with antibiotics! Find out the answers to your questions in this article

When antibiotics enter the system they naturally destroy some of the body's good bacteria as well as the bad, and this disruption is thought to be the reason for side effects such as diarrhoea or thrush. Many people, when prescribed antibiotics, choose to supplement their natural bacteria with a friendly bacteria supplement, or to eat plenty of yoghurt.

Your local pharmacist may recommend probiotics when dispensing antibiotics.

Will the probiotics survive?

Two strains of natural bacteria in particular, Lactobacillus rhamnosus Rosell-11 and Lactobacillus acidophilus Rosell-52 have seen numerous clinical trials conducted ALONGSIDE antibiotics, and can safely be taken AT THE SAME TIME as antibiotics. The recommended use for a supplement containing this combination would be as follows:

  • Take one capsule daily with breakfast*, until antibiotics course is finished, and preferably for one week after.
  • Continue taking until pack is completed and add a second pack if the antibiotic treatment lasts more than one week.
  • Some probiotics may be used on an ongoing basis.

* Can be taken at the same time as antibiotics - these two strains have been clinically trialled alongside antibiotics and found to reach the gut alive.

The extensive research behind these two strains sets them apart from many live cultures supplements on the market today, and makes them a suitable choice for anyone who wishes to take natural bacteria during their course of antibiotics. Furthermore these two strains, Lactobacillus rhamnosus Rosell-11 and Lactobacillus acidophilus Rosell-52, have been tested and shown in-vitro to survive stomach acidity and bile salts.

Healthcare practitioners can read about the clinical research behind these strains on the Probiotics Database.

Will the antibiotics survive?

Yes, the antibiotics will be unaffected by the probiotics. There is no research to suggest that probiotics interfere with antibiotics, and increasingly doctors and GPs are recommending live cultures supplements or yoghurts to be taken with a course of antibiotics.

Taking other probiotics

If you are taking a probiotic other than the two Lactobacillus strains mentioned above, it is best to wait 1 to 2 hours after your antibiotics before taking the friendly bacteria supplement (with the exception of 'Saccharomyces boulardii' which is a yeast and therefore won’t be killed by antibiotics). If you are taking a probiotic from a different supplier, perhaps a yoghurt or another supplement containing live cultures of natural bacteria, it is best to ask your supplier about timings.

However as a general idea, many companies tend to recommend waiting 1 or 2 hours after taking antibiotics before taking your probiotics. After 1 or 2 hours, the antibiotics will have passed through the body, and at this stage it is safe to take a probiotic without worrying about the natural bacteria being destroyed. It is still generally recommended to take probiotics every day during your course of antibiotics; this way you can replenish your friendly bacteria on a daily basis, before your digestive system is upset by a longstanding microbial imbalance.

When might other probiotics be appropriate?

What about children?

Children aged 1 year and up can also take Lactobacillus rhamnosus Rosell-11 and Lactobacillus acidophilus Rosell-52, which have been trialled in children also. However, parents may wish to seek a supplement especially formulated for children’s gut health. Research into the impact of antibiotics on a child's microbiome suggests that, at this young age the most important thing is to holistically support the gut microflora to mature, rather than focusing solely on the antibiotic. By using a probiotic suited to supporting the child’s microflora, as well as encouraging plenty of fermented foods and yoghurt (preferably not sugary) this could be a good way to support children throughout the course of antibiotics.

What if I am a woman with intimate health issues?

If you are a woman taking antibiotics for an intimate health issue, it might be worth considering probiotic strains which are well researched for women's intimate health, such as Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14.

Other tips for people on antibiotics

  • Eat fermented foods or prebiotic foods, as these can help to the microbiota return to normal and improve gut health after a course of antibiotics
  • Avoid alcohol, even if you're allowed to drink with your course of antibiotics. Alcohol can disrupt the gut microbiome too and also negatively impact immune function, which may hinder your body's efforts to fight infection
  • Avoid refined sugary foods, as these will feed the bad bacteria and yeasts which often overgrow due to antibiotic use
  • Ensure you complete your course of antibiotics; many people give up due to bad side effects, but probiotics could help with this and make it possible for you to finish to prescribed dose
  • Don't let the antibiotics do all the work - eat a healthy diet and include a selection of immune-boosting foods containing vitamin C and other antioxidants, including citrus fruits and green leafy vegetables

In conclusion

  • Take probiotics with your antibiotics instead of waiting to finish your course of antibiotics.
  • If taking L. rhamnosus Rosell-11 & L. acidophilus Rosell-52 consider taking with breakfast, whether or not this coincides with your antibiotics.
  • If taking a different probiotic or live cultures supplement, simply wait 1 or 2 hours after your antibiotics before taking probiotics.
  • Always follow your doctor's advice and never finish a course of antibiotics early.

If you have already finished a course of antibiotics before being recommended a friendly bacteria supplement, better late than never; by all means take the probiotic now! But for next time, you know you can take them during as well as after.

You may also wish to read our FAQ, At what time should I take probiotics?