Probiotics vs Antibiotics (Which One Is Better?)

We all know that antibiotics are important for fighting bacterial infections, but what about probiotics? Increasingly, probiotics are being recommended as a way to improve gut health and reduce the need for antibiotics. So which is better for you – probiotics or antibiotics?

Scientists define probiotics as live microorganisms that promote gut health. In comparison, antibiotics have gained popularity as compounds that wipe out pathogenic bacteria.  

Nonetheless, to date, probiotic use remains controversial due to a lack of research, and antibiotic use is surrounded by a lot of concerns.

In this article, you will find details regarding the efficacy, safety, and contraindications of probiotics and antibiotics and whether you can use them together.

So, keep reading to find out everything you need to know about them.

What is the Difference Between Antibiotics and Probiotics?

Antibiotics and probiotics can be differentiated on the basis of how they work.

Probiotics are certain bacterial or yeast species introduced into the gut to re-establish the microbial equilibrium, which helps prevent or treat infections. Compared to this, antibiotics are potent compounds that kill bacteria to cure diseases and infections in the body.

Apart from this, these two can also be compared on the basis of their uses, contraindications, and their safety profile.

Probiotics vs Antibiotics – Use Case/Benefits

Although probiotics have been extensively used for decades, their formal term was first compiled in 1965 by the scientists Lilly and Stillwell. Since then, numerous studies have evaluated their potential role in different fields like health, medicine, dermatology, and even oral health.

For instance, a review compiled all the potential benefits of probiotics.

And according to it, they can be trusted to relieve gastrointestinal concerns like bloating or diarrhea. 

Not only that, but they also relieve Helicobacter pylori infections, inflammatory bowel disease, female urogenital infections, and even surgical infections.

Another 2020 review compiled and evaluated the clinical data on the dermatological applications of probiotics. It revealed that probiotics seem effective in curing inflammatory skin diseases such as acne. 

They promote wound healing and may even improve response to skin cancer treatments or prevent it.

Moreover, some oral health enthusiasts reviewed 15 fifteen articles, out of which 12 were high-quality randomized control trials. They concluded that probiotics help maintain oral health and decrease the incidence of oral infections.

Furthermore, according to the position statement of the International Society of Sports Nutrition (ISSN), probiotics are highly beneficial in optimizing the health, performance, and recovery of athletes.

Now coming towards antibiotics, these have been in use since ancient times but gained proper recognition in 1928 after the discovery of penicillin by Alexander Fleming. 

Since then, rigorous research has been done to discover new antimicrobial compounds or evaluate the effectiveness of previous ones.

A summary of the potential use of antibiotics can be found in a 2019 review. According to it, antibiotics can be used both as a prophylactic and pre-emptive medicine in addition to being a treatment.

Here, a pre-emptive or prophylactic therapy with antibiotics reduces the risk of colonization of potentially infective microbes.

For instance, it may be prescribed before performing organ transplants in patients whose blood harbors the cytomegalovirus (CMV) or before a surgical or dental procedure. Also, these may be given to prevent yeast (candida) infection in ICU patients or to control bacterial (pseudomonas aeruginosa) colonization in cystic fibrosis patients.

Regardless of these benefits, various anti-bacterial drugs are prescribed for treating bacterial infections such as meningitis, ear infection (otitis), skin infections (impetigo), bacterial angina, pneumonia, or urinary tract infections (cystitis).

Probiotics and Antibiotics – Contraindications 

You should avoid taking certain antibiotics with alcohol, other prescription drugs, and in some health conditions. This is because, according to NHS, drinking alcohol with antibiotics such as metronidazole, tinidazole, linezolid, or doxycycline may make you sick. It may also cause side effects or render the treatment ineffective.

Next, antibiotics such as rifampicin and rifabutin should not be taken with oral contraceptives as they reduce their birth control effectiveness.

Moreover, always discuss your previous prescription with your doctor because some antibiotics may react with arthritis medicines, antihistamines, antidepressants, anticoagulants, antifungals, diuretics, muscle relaxants, multivitamins, mineral supplements, etc.

Now in the case of probiotics, these are basically contraindicated in individuals with a weakened immune system.

For instance, according to Sharp Healthcare, they may cause disease development in immunocompromised individuals.

Moreover, they should also be avoided by those who are allergic to probiotic products or those who are prone to bacterial translocation from the gut to blood resulting in infection. Some examples of such cases are HIV patients or individuals who are on immunosuppressants after organ transplants.

Cancer patients receiving chemotherapy or people with conditions like irritable bowel syndrome or short gut syndrome should also avoid probiotics.

Safety – Probiotics vs Antibiotics

Antibiotics may cause mild to severe side effects and complications. The less severe side effects may look like a rash, diarrhea, nausea, and yeast infections. However, antibiotics may cause Clostridium difficile infection, antibiotic resistance, or life-threatening allergic reactions in more severe cases.

Also, not all antibiotics are safe during pregnancy. 

Thus, if there is an unavoidable need, your doctor will consider multiple factors, like your trimester, before suggesting an antimicrobial treatment.

Now coming to probiotics, these are generally considered safe and are well tolerated.

Nonetheless, drugs.com and WebMD have still listed some rare side effects that you may look out for.

These include symptoms of an allergic reaction (hives, rash, etc.), dizziness, weight loss, thirst, bone pain, lethargy, taste disturbance, constipation, abdominal pain, flatulence, increased phlegm, etc.

Additionally, there is a lack of research to support probiotic use during pregnancy, but still, it is generally considered safe for expecting mothers.

Can you use Probiotics with Antibiotics?

Yes, you can take probiotics with antibiotics only on your doctor’s recommendation. In fact, they may help to restore the gut microbiome as taking antibiotics modifies the microbial diversity in the gut. 

But then, why don’t doctors prescribe probiotics with antibiotics, you may ask?

It is because none of the research has generated any conclusive findings in this regard.

But still, the Center for Disease Control and Prevention (CDC) is actively evaluating the different aspects of this combination therapy because studies with positive results have given some hope.

So, here is what will happen if you take probiotics with antibiotics.

Benefits of Antibiotic-associated Diarrhea and Clostridium difficile disease

Taking antibiotics, especially broad-spectrum ones, may induce dysbiosis of the gut microbiota, which may cause diarrhea and colitis.

Here, C. difficile is a pathogenic bacterium that is also the causative agent for colitis and may lead to the development of an inflamed colon and diarrhea.

For this reason, scientists evaluated the role of some potential probiotic strains in preventing such antibiotic complications.

A 2020 study reported that probiotics replenish the gut microbiome, support the intestinal barrier function, and strengthen the immune system, which may prevent antibiotic-associated diarrhea (AAD).

Also, a meta-analysis of 25 randomized control trials identified three probiotics: Saccharomyces boulardii, Lactobacillus rhamnosus GG, and probiotic mixtures that are effective in preventing AAD.

Similarly, six randomized control trials found that the probiotic strain Saccharomyces boulardii may treat and prevent aggravation of Clostridium difficile disease due to antimicrobial therapy.

Probiotics and Antibiotic resistance

Using probiotics to prevent antibiotic resistance is a relatively new concept that requires more significant studies to prove its positive value and application.

For instance, contrasting results were observed in a 2021 study that was performed to check the effect of 11 probiotic strains on antibiotic naive participants. Surprisingly, for some participants whose gut was permissive to the colonization of new species, the probiotics reduced the number of antibiotic resistance genes.

However, for others, probiotic supplementation after an antibiotic course prevented the decrease in antibiotic-resistant species in the gut and instead supported their bloom.

Hence, the effect of probiotic supplementation with antibiotics may vary from person to person.

Probiotics After Antibiotics – A Good Idea?

No, taking probiotics after antibiotics without your healthcare provider’s approval is not a good idea. The reason behind this is that most studies on probiotics have generated controversial findings.

On top of this, neither the US Food and Drug Administration (FDA) nor any other European regulators have approved the use of probiotics after antibiotics.

For instance, even though a 2012 meta-analysis of 82 studies did detect a positive correlation between taking probiotics after antibiotics, it could not detect the specific strain that works because of the inconsistency of the probiotic cocktails used in every study.

In addition to this, another study I referred to in the above section also found that probiotic supplementation after an antimicrobial therapy may, in some cases, delay the recovery of the normal gut microbiota.

Nonetheless, you don’t stop eating food with antibiotics, do you? 

And most of us are already consuming some kind of fermented foods and dairy products in our diet. This could mean that natural probiotic foods may have a lower risk-to-benefit ratio than probiotic supplements.

So, here are the two probiotic foods you can consume to restabilize your intestinal microbiome if your doctor hasn’t clearly abstained you against them. 

Furthermore, remember to discuss these foods with your doctor as well before incorporating them into your diet.

Best Probiotics to Take With Antibiotics

• Yogurt

In order to produce yogurt from milk, the Streptococcus thermophilus and Lactobacillus bulgaricuss bacteria are allowed to ferment the lactose in milk into lactic acid.

Therefore, according to the Codex Alimentarius and other national regulatory agencies’ guidelines, standard yogurt may contain a minimum of 100 million live cultures per gram.

Hence, since yogurt has so many good bacteria, it might be the ideal food to fix your gut microbiota balance.

• Kimchi 

For producing kimchi, the probiotic lactic acid bacteria are allowed to ferment the vegetables, most commonly cabbage. And the best part is that the process of kimchi formation eradicates the growth of putrefactive bacteria.

Therefore, like yogurt, kimchi also has an abundance of many bacterial species. 

Still, the lactic acid bacteria in it is the main probiotic that may help to redeem your gut health after an antibiotic course.

What is Better, Probiotics or Antibiotics?

Both antibiotics and probiotics work best in different scenarios; hence, none of them can be considered better than the other. For instance, if you fall ill due to a bacterial attack, only an antibiotic will help to reduce your body’s infectious load and cure the disease.

However, since antibiotics indiscriminately kill bacteria, good microbes may also die in the process. In this case, probiotics may help re-establish the normal microbial diversity in your gut. And a stable gut microflora also regulates mood, enhances nutrient absorption from the gut, helps prevent disease, and promotes overall health.

Yourbiology’s Gut+ is one such formula that contains a synergistic blend of both pro and prebiotics to help strengthen immunity and reverse any damage that antibiotics might have caused to your gut microbiome.

FAQs

What is it called when antibiotics kill good bacteria?

Antibiotics may simultaneously kill the good bacteria while targeting the bad ones. This may upset the gut’s natural microbial balance, which induces a state known as gut dysbiosis.

How long to take probiotics after antibiotics?

You should take probiotics for several weeks after antibiotics with your doctor’s recommendation.

Are probiotics better than antibiotics?

No, both are useful, and your situation will determine your preference. Therefore, if you want to restabilize the gut, taking probiotic therapy is better. Whereas, if you want to treat an infection, antibiotics offer a better deal.

Can I take probiotics with antibiotics for UTI?

Yes, you may take probiotics with antibiotics for Urinary Tract infections if your doctor recommends them.

What is the best probiotic when on antibiotics?

According to the available research, probiotic species in the genus lactobacillus, Bifidobacterium, and the yeast Saccharomyces boulardii are mostly compatible with antibiotics. (As found in Yourbiology Gut+)

To be more specific, the preferred bacterial species might be, Lactobacillus acidophilus Rosell-52, Lactobacillus rhamnosus Rosell-11, and Bifidobacterium lactis Lafti B94.

Bottom Line 

To conclude, both probiotics and antibiotics have different mechanisms of action. Therefore, you may use probiotics to prevent disease as they repopulate your gut’s microbial diversity.  Compared to this, antibiotics may help treat bacterial infections as they inhibit the growth and division of bacteria.

The complimentary benefit of these two has prompted the use of antibiotics and probiotics together.

Nevertheless, always consult your doctor before using probiotics and antibiotics, either individually or simultaneously.