Antibiotics are crucial tools for overcoming serious infections. However, they can often kill beneficial bacteria that live in the digestive tract and elsewhere along with the harmful invaders. As long ago as 2010, scientists had found evidence that antibiotics can disturb the ecology of the gut. A study of the bacterial populations in three women given ciprofloxacin showed that the beneficial bacteria in their digestive tracts were wiped out (1). As a result, a person who has had a course of treatment may experience diarrhea or other digestive difficulties. Sometimes health professionals recommend probiotics as an antidote for these problems. Can probiotics really help you recover from antibiotics more quickly?
How Can You Recover from Antibiotics?
Q. My doctor prescribed an antibiotic (levofloxacin or Levaquin) and a probiotic (Primadophilus) for an infection. I am to take one pill of each per day, but it seems to me like one cancels out the other.
The doctor says there are no conclusive guidelines on how these are to be taken. Should I take one in the morning and the other in the evening each day, or take the probiotic after the antibiotic series is finished? Do you have any recommendations to help me recover from antibiotics?
A. People often turn to probiotics, bacteria considered beneficial for the digestive tract, to speed recovery from a course of antibiotic therapy. That because antibacterial drugs can disrupt the ecology of the gut bacteria. In theory, people who swallow certain bacteria will recover from antibiotics and the disruption they cause more quickly.
The Use of Probiotics to Recover from Antibiotics Is Not Established:
The science surrounding this concept has been controversial. Recently, Israeli scientists who studied the use of popular probiotics following antibiotic treatment demonstrated that these “good bacteria” can actually slow recovery of the normal microbiota (2). What may work better is to restore the microbial ecology with a transplant of stool taken before the course of antibiotics. This option will not appeal to everyone, however.
Medical Consensus Advisory
Many health care providers believe that probiotics will speed recovery from antibiotics. However, scientists know too little about this complex field for providers to be confident in their recommendations.
You can hear the lead researcher describe this groundbreaking work in our podcast interview, Show 1159. To learn more about the microbiota of the digestive tract and its care and feeding, you can listen to Drs. Erica and Justin Sonnenburg in Show 1156.
What Readers Have Done to Recover from Antibiotics:
Some readers report that they have had success taking probiotics, but many more report that they have eaten foods such as yogurt containing natural probiotic bacteria.
Alison reported this experience:
“I had a serious tooth infection and had to take antibiotics for over two months. The drugs made me so sick that whatever I ate went right through me, and I lost nine pounds. My stool turn white, and my lower gut felt like it was twisting and shaking every time I had the urge to go to the bathroom. The doctors kept giving me more antibiotics to clear up this condition.
“Then I started to take Nutri-Health probiotics at first 4 a day, then 2 per day, and then one per day for a WHOLE YEAR. Even now 4 years later I still have to take one probiotic at least every other day or my lower gut hurts.
“All the doctors want to do is give me antibiotics after examining me and telling me they can’t find anything wrong. I tell them to keep their drugs unless I really do have a serious infection/illness. Jarrow Formulas probiotic works well also. It takes research to decide which brand to use because I notice a few formulas have laxatives, and other ingredients I considered junk in them.”
Rebekah is a health care professional who advises eating yogurt:
“As a nutritionist working with the Women, Infant, Children program, I have recommended consuming 1 cup of yogurt w/ active, live cultures to help protect against yeast infection because the good bacteria produced by the gut is compromised with ingesting an antibiotic.”
Anner had a difficult situation due to a toothache:
“A dentist prescribed clindamycin to prevent infection, as I had to travel with a slight pain in a tooth that had been capped. After 6 or 7 days, I called to advise him that I was having diarrhea for the past few days – he said continue on to finish the prescription. Then I read the handout from the pharmacy and saw ‘seldom fatal’ so I stopped and called my internist who advised to immediately begin Florastor (otc probiotic) which helped a lot. When I got to my doctor and learned I had C. difficile, I had to take a stronger medicine – 2 rounds of it – before my stomach was back in reasonable order. It took weeks to be back to normal.
“I asked my pharmacist if people often responded poorly to clindamycin and was told yes and that it is the prescription of choice for dentists. Either no one tells their dentist they got sick or big pharma is offering huge incentives for them to prescribe it. The dentist never called to see how I was doing even after I sent him a non-judgmental email regarding the benefits of Florastor.
“My lesson for the day – read all pharmacy handouts before taking medicine and weigh the benefits. You know what I mean – do you really want a pill to combat depression that will cause suicidal thoughts?
“When doctors prescribe antibiotics and don’t tell people about suitable probiotics (they differ with when to take so as not to interfere with benefits of antibiotics) they are doing a serious dis-service to their patients. Ask anyone who’s had C. difficile and you’ll hear horror stories. I had a terrible experience with pain, holding in food, digestion, and worry as I am ordinarily a very healthy person and didn’t think a dentist would prescribe a medicine that is ‘rarely fatal’ as a deterrent for a minor pain. I tried to notify CDC but their website reporting was not easy.”
Clindamycin is not the only culprit. HB had a bad reaction to Cipro:
“My doctor prescribed Cipro in late June for a bladder bacterial infection. After a week, that stuff completely wiped me out, including my good bacteria. I have suffered with such reflux and terrible burning pain in the abdominal area had to have Upper GI done -plus endoscopy. This had never happened to me until about two weeks after I had taken this horrible antibiotic. Now I have the reflux problem and it may have caused other problems.
“I really feel that this medication should not be given out so freely, especially when there are other meds that can do the job without all these problems from antibiotics. Personally, I should have questioned this because I have a terrible time with antibiotics and would have never taken this one had I known what I was going to have to go through. One other thing that really irritates me is, they give everyone, no matter what weight, age you are, the same dose. I say ‘one size’ does not fit all.
“By the way, for others out there–the symptoms don’t always appear right away. This can happen anywhere from 2-5 weeks after you finished the medication, which I found out just recently. What a kicker that was.”
LP has a tragic story about an elder:
“My mother fell, bruising her thigh bone. She required extensive bed rest, resulting in UTI and pneumonia. Course of treatment was PIC in right shoulder area, massive amounts of antibiotics for 15 days. No one questioned the long use of the antibiotics in her stays in 3 hospitals and one for weeks of physical therapy. She received the meds January-February.
“She died in March of the same year due to diarrhea caused by the use of these antibiotics and doctors not replacing the good bacteria. They would not even allow me to bring her yogurt, which she had eaten daily for years. In her last days of a very painful death, the dietitian told me the yogurt along with Rx to replace good bacteria could have saved her life.
“Even though I argued with several of her doctors, they still refused to try it. My mom was 86 yrs old.”
DG had an unfortunately similar experience:
“Wow, such a similar story to ours. My mother-in-law was 92, still able to live at home alone. She fell, life alert necklace called 911. Taken to the hospital, Catheter.. Subsequent MRSA contracted, Heavy vancomycin, transferred to REHAB, more Vanco, C. Diff overtook her intestines and she suffered for 2 weeks, went into a painful stupor, nurses said it was her time! Body was shutting down.
She was rushed to emergency, went on life support and the C. Diff and uncured MRSA killed her. Intensive care doctors said it would be inhumane to treat her just so she could go back to the nursing home. She lost 40 lbs and all this happened in 3 months! C diff is BAD stuff. Couldn’t even sue the rehab because she had no living spouse.”
Stephie G has struggled with symptoms for months:
“I had a couple of rounds of Cipro for 3 separate urinary tract infections this year. My last round was in late July and I’ve had such stomach issues since. I went to a gastro and he gave me an endoscopy and told me he believed the problem was caused by the cipro. All of my tests came back negative but he did diagnose me with GERD. I’ve already lost around 30 pounds and I find it hard to eat anything. Even food that is binding still causes diarrhea.
“I am in digestive hell and I don’t know what to do anymore. Bentyl, a stomach relaxer, helped somewhat but just for a little while. I also try to take a probiotic everyday. How much longer will this last? My stomach makes all kinds of crazy noises no matter what I eat and there is no rhyme or reason to single out any specific catalyst. Rice won’t bother me one day but the next time I eat it I feel really sick. The nausea is unbearable.
“So many people believe this is all stress related. I just wish I had some answers to make sense of this…and some words of encouragement and perhaps a time frame for when this will finally be over.”
Faith found that probiotics were very helpful:
“My doctor had me on clindamycin for three weeks, he also had me on mega probiotics and the Florastor, saccharomyces boulardii, Theralac, and a pharmacy grade probiotic. I also drank kefir lactose free. I was fine, afterwards, My doctor is rockstar,
“Anyhow, it takes sometimes months to get your gut flora back to normal there has to be a better way to cure people rather than give them antibiotics, to destroy the flora which is there for our immunity which is there for their protection.”
If you have found a way to recover from antibiotics, share your secrets with others. Post your comment below.