In contrast to the ongoing discussion about whether we should be taking probiotics during a course of antibiotics, many healthcare professionals would probably agree on the fact that consuming some beneficial bacteria after antibiotics is a good idea for helping to restore the gut microbiome.
The use of antibiotics will impact the gut microbiome. The extent of the effect is dependent on the type (e.g. broad spectrum vs. narrow spectrum) and duration (e.g. long term vs. sporadic use) of antibiotic use and also the individual’s overall health status.
Antibiotics can have negative effects on the gut microbiome including reductions in overall diversity, altered metabolic activity and increases in antibiotic-resistant genes. Chronic exposure to antibiotics has been associated with an increased risk of chronic disease (e.g. gastrointestinal and metabolic conditions), although the benefits of antibiotics in treatment of infections must always be recognised and balanced against any risks.
A recent review of the effect of using probiotics with an antibiotic treatment on the gut microbiome concluded that probiotic use seems to preserve alpha diversity and reduce changes to gut microbial composition that arise due to use of antibiotics. Research suggests it can take anywhere from a few weeks up to six months for the microbiome to recover from the effects of antibiotics, and the sooner we begin probiotic supplementation the better.
- Use of a probiotic after antibiotic use may support the gut microbiome.
- There are no specific species or strains of bacteria that are currently recommended, although it makes sense to use a probiotic that contains live and active bacteria, proven to survive the harsh conditions of the gastrointestinal tract.
- Duration of use of a probiotic post-antibiotic administration has not been prescribed, but typical recommendations are currently up to 1 week use.
- Consideration is needed regarding the individual user, the type of antibiotic (e.g. broad spectrum or targeted) and usage (short or long term) being considered when assessing appropriateness of probiotic recommendations following antibiotic use.