Should you take probiotics with antibiotics. What does the research say about combining probiotics and antibiotics. How do probiotics affect gut health during antibiotic treatment. What are the potential benefits and risks of taking probiotics with antibiotics.

The Debate: Probiotics and Antibiotics

The question of whether to take probiotics with antibiotics has been a subject of ongoing debate in the medical community. While some studies suggest potential benefits, others raise concerns about the practice. This article delves into the current research and provides a comprehensive overview of the topic.

What Are Probiotics?

Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. They are often referred to as “good” or “helpful” bacteria because they help keep the gut healthy. Common probiotic strains include various species of Lactobacillus, Bifidobacterium, and Saccharomyces.

How Do Antibiotics Affect Gut Health?

Antibiotics are designed to kill harmful bacteria, but they can also disrupt the delicate balance of the gut microbiome by eliminating beneficial bacteria. This disruption can lead to side effects such as diarrhea and may create an environment where harmful bacteria can thrive.

Evidence Supporting Probiotic Use with Antibiotics

Several studies have shown potential benefits of taking probiotics alongside antibiotics. A notable Cochrane review examined 23 studies involving 3,938 participants, focusing on various probiotic strains.

Key Findings from the Cochrane Review

• Significant reduction in antibiotic-associated diarrhea (8% in probiotic group vs. 19% in control group)
• No serious side effects attributed to probiotics
• Recommended strains: Lactobacillus rhamnosus or Saccharomyces boulardii at 5 to 40 billion colony forming units/day

The review concluded that probiotics had a protective effect against antibiotic-associated diarrhea, with a relative risk of 0.46 and a number needed to treat (NNT) of 10.

Are Probiotics Safe for Everyone?

While the studies showed no serious adverse events in healthy children, the authors cautioned against probiotic use in severely debilitated or immunocompromised children. They emphasized the need for further research in these high-risk populations.

Challenging the Conventional Wisdom

Despite the positive findings of some studies, recent research has challenged the routine use of probiotics with antibiotics.

The Weizmann Institute Study

A 2019 study from the Weizmann Institute of Science in Israel provided a different perspective on probiotic use after antibiotic treatment:

• Participants given probiotics after antibiotics showed delayed gut microbiome recovery (6 months) compared to those who didn’t take probiotics (3 weeks)
• Probiotics effectively colonized the gut but prevented the return of the original microbiome
• The study focused on one specific probiotic combination, suggesting results may vary with different probiotic strains or antibiotics

Alternative Approaches to Gut Health After Antibiotics

As the debate continues, researchers are exploring other methods to support gut health following antibiotic treatment.

Fermented Foods

Some studies suggest that consuming fermented foods like sauerkraut and kimchi may help support a healthy gut microbiome. These foods contain naturally occurring probiotics and may offer a more diverse range of beneficial bacteria.

Autologous Fecal Transplantation

An emerging area of research is autologous fecal transplantation, which involves:

1. Collecting a stool sample before antibiotic treatment
2. Freezing the sample for preservation
3. Reintroducing the sample to the gut after completing antibiotic therapy

Studies have shown promising results, with the gut microbiome returning to normal within 8 days using this method, compared to 21 days without intervention. However, this procedure is currently only approved for treating C. difficile colitis.

Understanding the Gut Microbiome

To fully appreciate the impact of antibiotics and probiotics on our health, it’s essential to understand the gut microbiome.

What Is the Gut Microbiome?

The gut microbiome refers to the trillions of microorganisms, including bacteria, fungi, and viruses, that inhabit our digestive tract. This complex ecosystem plays a crucial role in various aspects of our health, including:

• Digestion and nutrient absorption
• Immune system function
• Production of certain vitamins
• Protection against harmful pathogens
• Regulation of mood and cognitive function

Factors Influencing the Gut Microbiome

While genetics play a significant role in determining the composition of our gut microbiome, several other factors can influence its balance:

• Diet
• Stress levels
• Sleep patterns
• Exercise
• Medications, including antibiotics
• Environmental factors

Potential Side Effects of Probiotics

While probiotics are generally considered safe for most people, they can cause some side effects, particularly when starting a new regimen or taking high doses.

Common Side Effects

Clinical trials have reported the following side effects associated with probiotic use:

• Abdominal bloating
• Abdominal pain
• Gas and flatulence
• Nausea
• Changes in bowel movements (constipation or diarrhea)
• Increased phlegm production
• Changes in appetite
• Rash
• Taste disturbances

It’s important to note that these side effects are typically mild and often resolve as your body adjusts to the probiotics.

Choosing the Right Probiotic

If you’re considering taking probiotics, either with or without antibiotics, it’s crucial to choose the right product for your needs.

Factors to Consider

• Strain specificity: Different probiotic strains have different effects on the body
• Colony-forming units (CFUs): Look for products with at least 1 billion CFUs
• Viability: Ensure the product has a good shelf life and doesn’t require refrigeration (unless specified)
• Quality control: Choose reputable brands that undergo third-party testing
• Allergies and dietary restrictions: Check for potential allergens or unwanted ingredients

Consulting a Healthcare Professional

Before starting any probiotic regimen, especially if you’re taking antibiotics or have a health condition, it’s advisable to consult with a healthcare professional. They can provide personalized advice based on your individual needs and medical history.

The Future of Microbiome Research

As our understanding of the gut microbiome continues to evolve, so too does the potential for targeted therapies and interventions.

Emerging Areas of Research

• Personalized probiotics: Tailoring probiotic formulations to an individual’s unique microbiome
• Microbiome testing: Developing more accurate and accessible methods for analyzing gut bacteria
• Prebiotics: Investigating the role of non-digestible fibers in supporting beneficial gut bacteria
• Synbiotics: Combining probiotics and prebiotics for enhanced effects
• Microbiome-based therapeutics: Developing novel treatments for various health conditions based on microbiome research

The Need for Further Studies

While the field of microbiome research is rapidly advancing, many questions remain unanswered. Further studies are needed to:

• Determine the long-term effects of probiotic use
• Identify the most effective probiotic strains for specific conditions
• Understand the complex interactions between probiotics, antibiotics, and the host microbiome
• Develop standardized protocols for probiotic use in clinical settings
• Investigate the potential of microbiome-based therapies for a wide range of health conditions

Practical Tips for Maintaining Gut Health

Regardless of whether you choose to take probiotics with antibiotics, there are several steps you can take to support your gut health:

Dietary Considerations

• Eat a diverse range of fruits, vegetables, and whole grains to provide a variety of nutrients for your gut bacteria
• Include fermented foods in your diet, such as yogurt, kefir, sauerkraut, and kimchi
• Limit processed foods, artificial sweeteners, and excessive sugar intake
• Stay hydrated by drinking plenty of water

Lifestyle Factors

• Manage stress through techniques like meditation, yoga, or deep breathing exercises
• Get regular exercise, which can promote diversity in gut bacteria
• Prioritize sleep, as poor sleep patterns can negatively affect the gut microbiome
• Avoid unnecessary antibiotic use and follow your healthcare provider’s instructions when antibiotics are necessary

Monitoring Your Gut Health

Pay attention to changes in your digestive health and overall well-being. If you experience persistent digestive issues or other health concerns, consult with a healthcare professional for proper evaluation and guidance.

The Ongoing Debate: Weighing the Evidence

The question of whether to take probiotics with antibiotics remains complex, with evidence supporting both sides of the argument. While some studies demonstrate potential benefits, others raise concerns about long-term effects on the gut microbiome.

Key Points to Consider

• Individual responses to probiotics can vary significantly
• The effectiveness of probiotics may depend on factors such as the specific antibiotic used, the probiotic strain, and the individual’s unique microbiome
• More research is needed to establish clear guidelines for probiotic use with antibiotics
• Alternative approaches, such as dietary changes and lifestyle modifications, may also support gut health during and after antibiotic treatment

Making an Informed Decision

When considering whether to take probiotics with antibiotics, it’s essential to:

• Discuss the potential benefits and risks with your healthcare provider
• Consider your individual health status and any underlying conditions
• Be aware of the current state of research and its limitations
• Monitor your body’s response if you do choose to take probiotics

Ultimately, the decision to use probiotics alongside antibiotics should be made on a case-by-case basis, taking into account the latest scientific evidence and individual health considerations.

Should you take probiotics with antibiotics?

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 7, 2022.

There is controversy about whether you should routinely take probiotics with antibiotics and the question cannot be answered with a straight yes or no.

Evidence for taking probiotics with antibiotics includes a Cochrane review which reported that children who were given a course of probiotics after antibiotics had less diarrhea. Evidence against taking probiotics with antibiotics includes a 2019 Italian study that reported that the gut microbiome of people given probiotics after antibiotics took six months to return to its normal state compared to only three weeks for those not given any probiotics.

More studies are needed before a definite statement can be made.

What studies support giving probiotics with antibiotics?

A Cochrane review of 23 studies (3938 participants) investigated giving probiotics containing either one or a combination of the following: Bacillus spp. , Bifidobacterium spp., Clostridium butyricum, Lactobacilli spp., Lactococcus spp., Leuconostoc cremoris, Saccharomyces spp., or Streptococcus sp.

Results from 22/23 trials that reported on the incidence of antibiotic-associated diarrhea show a significant benefit from probiotics compared to active, placebo, or no treatment control (8% in the probiotic group compared to 19% in the control group). None of the 16 trials (n = 2455) that reported on side events documented any serious side events attributable to probiotics with the most common ones being rash, nausea, gas, flatulence, abdominal bloating, abdominal pain, vomiting, increased phlegm, chest pain, constipation, taste disturbance, and low appetite. The author’s concluded that there was a protective effect of probiotics for preventing antibiotic-associated diarrhea. The relative risk was 0.46 (95% CI 0.35 to 0.61) and the NNT was 10.

The authors considered Lactobacillus rhamnosus or Saccharomyces boulardii at 5 to 40 billion colony forming units/day to be the most appropriate choice. They also commented that although no serious adverse events were observed among the otherwise healthy children in these trials, serious adverse events have been observed in severely debilitated or immuno-compromised children with underlying risk factors (eg, central venous catheter use), and advised that probiotics should be avoided in pediatric populations at risk for adverse events until further research has been conducted.

What studies do not recommend giving probiotics with antibiotics?

Researchers from the Weizmann Institute of Science in Israel and other institutions reported that the gut microbiome took longer to return to normal in those people given an 11-strain probiotic treatment for four weeks following a course of antibiotics. This was despite the probiotics effectively colonizing the gut with healthy bacteria. The trouble was the presence of the new bacteria and yeasts strains prevented the gut microbiome from returning to normal for the full six month study period.

Conversely, the gut microbiome in those given no probiotics returned to normal within three weeks of going off the antibiotics. “ The authors did conclude that this study just examined one type of probiotic, and a different probiotic may be helpful in patients taking different antibiotics. However, they did point out the findings of the study imply that the traditional practice of taking a probiotic after antibiotic may not be beneficial.

More research is needed to determine if other options to strengthen the gut microbiome, such as fermented food products (eg, sauerkraut and kimchi) or fecal transplantation, is beneficial. Studies have shown that autologous fecal transplantation, which involves collecting stool samples before going on antibiotics and freezing them, brought the gut microbiome back to normal within eight days once the stool was returned to the gut following antibiotic treatment. It took 21 days for the gut microbiota in the group that didn’t undergo fecal transplantation to return to perfect health. Currently, however, the only approved indication for autologous fecal transplantation is for people with C. difficile colitis, which is an inflammation of the colon caused by the bacteria Clostridium difficile.

What are the most common side effects of probiotics?

The most common side effects reported with probiotics in clinical trials included:

• abdominal bloating
• abdominal pain
• chest pain
• constipation
• flatulence
• gas
• increased phlegm
• low appetite
• nausea
• rash
• taste disturbance
• vomiting.

What is the gut microbiome?

Our digestive tract is home to trillions of bacteria as well as fungi and viruses – these are known as the gut microbiome.

The makeup of this biome is largely genetically determined; however, it is heavily influenced by several factors such as whether we are born naturally (vaginally) or by cesarean section, if we were breastfed, our use of antibiotics, and our exposure to chemicals, pesticides, and other toxins.

Scientists now know that this microbiome is critical to our overall well-being. Some call it our second brain. Small imbalances can cause significant changes to our mental health and in the appearance of our skin and has been linked to almost every known condition such as Alzheimer’s disease, multiple sclerosis, rheumatoid arthritis, and Type 2 diabetes.

An imbalance may also cause constipation, diarrhea, skin rashes, yeast infections, and a suppressed immune system. Your likelihood of putting on weight also comes down to your microbiome and the influence it has on your response to insulin and thyroid gland function.

What are probiotics?

Probiotics are live bacteria and yeasts that are beneficial for health. They are often referred to as ‘good’, ‘helpful’, or ‘healthy’ bacteria.

Probiotics are available as dietary supplements and can be brought over the counter from a drug store, pharmacy, or health store. Probiotics are also found naturally or added to foods such as dark chocolate, yogurt, miso soup, pickles, sauerkraut, tempeh, or kefir.

What is the rationale behind taking probiotics with antibiotics?

Taking an antibiotic for an infection can kill beneficial bacteria that live in your gut.

Probiotics may be taken orally to restore any imbalance in the normal intestinal or urogenital flora. This is the rationale behind taking probiotics with antibiotics. Severe antibiotic-induced diarrhea can also lead to an infection with Clostridium difficile, also known as C. difficile, a bacteria which can cause dangerous inflammation in your colon (colitis).

Experts have hypothesized that If you suffer from stomach cramping, gas or diarrhea when you take antibiotics, adding a probiotic may help to lessen, or even prevent, these symptoms. The addition of a probiotic will also reintroduce helpful bacteria into your digestive tract that have been killed or had their numbers reduced by the antibiotic.

How should I take probiotics with antibiotics?

If you do decide to take a probiotic with an antibiotic, start it the same day you start the antibiotic, but do not take it at exactly the same time as the antibiotic. Allow at least two hours to elapse after taking your antibiotic before you take your probiotic.

Probiotics are usually taken twice a day on an empty stomach. They should then be continued for at least several weeks after your course of antibiotics has finished, although some people take probiotics daily to not only continue to help digestion but to boost their immune system and enhance the absorption of some nutrients.

If you wish to take probiotic supplements, choose a high-quality probiotic made by a reputable company that contains at least one of the following: Lactobacillus rhamnosus, Saccharomyces boulardii, or Bifidobacterium sp. at 5 to 40 billion colony units/day.

Do prebiotics help return the gut microbiome to normal?

Prebiotics are foods for probiotics and include fiber-rich foods such as fruits, vegetables, cereals.

Mixing prebiotics with probiotics, such as yogurt with fruit and cereal or sauerkraut with a vegetable stir fry could be helpful for your gut, although there is no scientific evidence to support this.

Good prebiotic foods include vegetables such as artichokes, asparagus, garlic, onions, and any green vegetable; fruits such as bananas, berries, and tomatoes; herbs such as chicory or garlic; grains like barley, oat, and wheat; and other fibers such as inulin that may be available on its own or added to foods such as granola bars, cereal, and yogurt.

References

• Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2015 Dec 22;(12):CD004827. doi: 10.1002/14651858.CD004827.pub4. Update in: Cochrane Database Syst Rev. 2019 Apr 30;4:CD004827. PMID: 26695080.
• Suez J, Zmora N, Zilberman-Schapira G, et al. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell. 2018 Sep 6;174(6):1406-1423.e16. doi: 10.1016/j.cell.2018.08.047. PMID: 30193113.
• Goderska K, Agudo Pena S, Alarcon T. Helicobacter pylori treatment: antibiotics or probiotics. Appl Microbiol Biotechnol. 2018 Jan;102(1):1-7. doi: 10.1007/s00253-017-8535-7. Epub 2017 Oct 26. PMID: 29075827; PMCID: PMC5748437.
• Neut C, Mahieux S, Dubreuil LJ. Antibiotic susceptibility of probiotic strains: Is it reasonable to combine probiotics with antibiotics? Med Mal Infect. 2017 Nov;47(7):477-483. doi: 10.1016/j.medmal.2017.07.001. Epub 2017 Aug 7. PMID: 28797834.
• Guandalini S. Probiotics for prevention and treatment of diarrhea. J Clin Gastroenterol. 2011 Nov;45 Suppl:S149-53. doi: 10.1097/MCG.0b013e3182257e98. PMID: 21992955.
• Do probiotics provide effective and safe protection against antibiotic-associated adverse effects? Best Practice Journal > 2015 > BPJ: 68 > Do probiotics provide effective and safe protection against antibiotic-associated adverse effects? https://bpac.org.nz/bpj/2015/june/probiotics.aspx

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Medical Disclaimer

What Are the Most Common Antibiotics?

Antibiotics are a common, important group of medicines that treat bacterial infections. Some antibiotics attack or break down the cell walls of bacteria, while others inhibit their protein production. This kills the bacteria or keeps it from reproducing and spreading.

Oral antibiotics are available in liquid, tablet, and capsule form. Topical antibiotics include skin creams, sprays, and ointments. Eye ointments, eye drops, and ear drops are also available. Severe infections may require injected or intravenous antibiotics.

Healthcare professionals prescribe different antibiotics to treat conditions such as strep throat, bronchitis, and inner ear infections. In this case, these infections are moderate to severe and have not improved with other treatments.

Antibiotics do not treat viral illnesses, such as a cold, the flu, or mono.

These drugs are grouped according to their antibacterial activity and chemical structure. Specific antibiotics fight certain bacteria, which makes it important to take the right kind. A healthcare professional may ask for a lab culture test to determine which antibiotics you need.

Read on to learn more about the most common types of antibiotics and which infections they treat. We also explore the common side effects of antibiotics, which can include gastrointestinal problems like nausea, vomiting, and diarrhea, as well as more serious effects.

Here are some types of antibiotics that doctors prescribe most often.

Penicillins

Penicillins are a common treatment for a variety of skin conditions. They also treat middle ear, kidney, and blood infections. Penicillin antibiotics are effective at killing Staphylococci and Streptococci infections. But some bacteria are resistant to penicillin, due to overuse.

Common penicillin antibiotics include:

• phenoxymethylpenicillin
• dicloxacillin
• amoxicillin with clavulanic acid
• ampicillin
• nafcillin
• oxacillin
• penicillin V
• penicillin G

Potential side effects include:

• nausea
• abdominal discomfort
• diarrhea
• headache
• yeast infection
• liver disease

Penicillin may cause allergic reactions, such as rashes, hives, and breathing difficulties.

Some medications that may interact with penicillin include oral contraceptives and the anti-inflammatories aspirin and probenecid.

Cephalosporins

Cephalosporins often treat gonorrhea, pelvic inflammatory disease, and sinusitis. They also treat urinary tract infections (UTIs), epididymo-orchitis, and cellulitis. Often, doctors prescribe cephalosporins to people who are allergic to penicillin.

Common cephalosporin antibiotics include:

• cefaclor
• cefazolin
• cefadroxil
• cephalexin
• cefuroxime
• cefixime
• cefoxitin
• ceftriaxone

Tetracyclines

Tetracyclines are a group of antibiotics with anti-inflammatory properties that can treat several bacterial infections. They commonly treat chest, urethral, and pelvic infections. Tetracyclines also treat inflammatory skin conditions, such as acne, rosacea, and perioral dermatitis.

Common tetracycline antibiotics include:

• doxycycline
• minocycline
• sarecycline

Children under 12 and pregnant or breastfeeding people should not take tetracyclines because they have the potential to stain developing teeth.

They can also cause inflammation or irritation of the esophagus. To prevent this, make sure to take doxycycline while sitting or standing upright, and have plenty of water. Also, it’s a good idea to avoid sun exposure, since doxycycline causes photosensitivity, which can lead to sunburn.

Finally, it’s best to take this type of antibiotic after eating to prevent nausea, vomiting, and diarrhea.

Minocycline has more potential side effects than doxycycline, though it’s less likely to cause photosensitivity. Possible adverse effects of minocycline include drug hypersensitivity syndrome, autoimmune reactions, and dizziness and headache. Also, using it for a long period may cause blue pigmentation of skin and nails.

Medications that may interact with tetracyclines include:

• systemic retinoids, such as acitretin, isotretinoin, and alitretinoin
• diuretics
• lithium
• anticonvulsants
• rifampicin
• celestipol
• oral contraceptives

Macrolides

Macrolides are an antibiotic group with anti-inflammatory and immunomodulatory properties. They can treat strains of bacteria that are resistant to penicillin. They are also a suitable option for people who are allergic to penicillin or cephalosporin.

These antibiotics commonly treat skin, soft tissue, respiratory, and sexually transmitted infections, including chlamydia. Healthcare professionals use them, for example, to treat skin conditions like acne, rosacea, erythrasma, and pityriasis lichenoides.

Types of macrolides include:

• erythromycin
• clarithromycin
• azithromycin
• fidaxomicin
• roxithromycin

Macrolides, especially erythromycin and clarithromycin, can adversely interact with certain medications. Reactions and toxicity are more common in older adults and people with renal or liver dysfunction.

Medications that may interact with macrolides include:

• calcium channel blockers, such as verapamil
• amiodarone
• methadone
• lithium
• amitriptyline
• citalopram
• anticoagulants, including warfarin and dabigatran
• digoxin
• benzodiazepines
• carbamazepine
• cimetidine
• clozapine
• colchicine
• theophylline

Fluoroquinolones

Fluoroquinolones, also called quinolones, can fight bacterial infections that are life threatening or challenging to treat. However, they are linked with antimicrobial resistance, so you shouldn’t take them unless it’s absolutely necessary.

Fluoroquinolones are the first-line treatment for prostatitis, along with severe cases of salmonellosis and shigellosis. Doctors also often use them to treat certain cases of epididymo-orchitis, gonorrhea, and tuberculosis. Sometimes, fluoroquinolones treat urinary, eye, and ear infections.

Types of fluoroquinolone include:

• ciprofloxacin
• ofloxacin
• levofloxacin
• moxifloxacin

For people with renal dysfunction, taking this type of drug may require adjustments to dosages of other medications. And, rarely, fluoroquinolone can cause serious adverse effects, especially in older adults.

Potential side effects include:

• tendon rupture
• aortic aneurysm rupture or dissection
• aortic and mitral regurgitation
• central nervous system excitation and seizures
• QT prolongation
• other cardiac conditions

Sulfonamides

Sulfonamides, also called sulfa drugs, are a type of synthetic antimicrobial that doctors prescribe when first-line treatments are ineffective or contraindicated. The most common type is sulfamethoxazole with trimethoprim, called co-trimoxazole. It treats conditions such as pneumocystis pneumonia and nocardiosis in people with weakened immunity, as well as infections of the lower urinary tract in children.

Types of sulfonamides include:

• sulfamethoxazole with trimethoprim
• sulfasalazine
• sulfacetamide
• sulfadiazine silver

Sulfonamides are unsafe during pregnancy because they increase the likelihood of pregnancy loss.

Potential side effects include:

• jaundice in newborns
• candidiasis
• folate deficiency
• headaches
• anorexia
• hyperkalaemia

Medications that may interact with sulfonamides include:

• warfarin
• sulfonylurea hypoglycemic agents
• phenytoin
• methotrexate

Glycopeptides

Glycopeptide antibiotics treat drug-resistant bacteria and gram-positive infections, including multidrug-resistant Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus, better known as MRSA.

Types of glycopeptides include:

• vancomycin
• dalbavancin
• oritavancin
• telavancin

Below, find answers to common questions about antibiotics.

What is antibiotic resistance?

Antibiotic resistance occurs when bacteria survive or resist antibiotic treatment. Bacteria change and mutate to protect themselves after coming into contact with an antibiotic or other bacteria. Once a type of bacteria is resistant, it passes these genes to other bacteria, which continue to grow. Eventually, they create a new strain of antibiotic-resistant bacteria.

Misusing and overusing antibiotics increases the likelihood of antibiotic resistance. Over time, this may lead to a shortage of medications that can effectively treat common infections.

How can I prevent antibiotic resistance?

To prevent antibiotic resistance, avoid taking antibiotics unless it is essential. Don’t take them for viral infections, such as a cold or the flu. Always follow the instructions from your healthcare professional about how much to take when. To prevent infections, clean your hands and living spaces regularly, and take steps to strengthen your immune system.

Are there any natural antibiotics?

Natural antibiotics include honey, thyme essential oil, and oregano essential oil. Extracts of garlic, cranberry, and myrrh also have antibiotic properties. Several herbs are effective antibiotics, including echinacea, turmeric, and ginger.

Natural UTI treatments include D-mannose and uva ursi, along with green, parsley, mint, and chamomile teas.

You can experiment with different combinations of natural treatments to find out which are most effective for your needs.

Antibiotics kill bacteria and prevent them from multiplying. They are valuable drugs that treat bacterial infections. It’s crucial to use them correctly and follow the healthcare professional’s instructions carefully.

It’s also important to be aware of the potential side effects and interactions of antibiotics. Speak with your doctor if you have any related concerns.

Antibiotics for the treatment of diarrhea caused by the bacterium Clostridium difficile in adults

Relevance

Clostridium difficile ( C. difficile ) is a bacterium that lives in the large intestine and does no harm to the body. However, when a person starts taking antibiotics for any reason, the C. difficile bacteria can increase and almost completely replace the colon’s natural bacterial environment. This overgrowth causes diarrhea caused by bacteria C. difficile (also known as C. difficile infection – CDI). Symptoms of infection include diarrhea, fever, and abdominal pain. The infection may be mild, but in many cases it is very serious and, if left untreated, can be fatal. There are many suggested treatments for CDI, but the most common is to stop taking the antibiotic that caused the infection and prescribe another antibiotic that kills the bacteria. Many antibiotics have been tested for efficacy in clinical trials and this review is about comparing these antibiotics. This review is an update of a previously published Cochrane review.

Methods

We searched the literature up to 26 January 2017. All randomized clinical trials comparing two different antibiotics or dose variations of a single antibiotic for the treatment of CDI (pseudomembranous colitis) were included in the review. We searched for trials comparing antibiotics with placebo (such as a sugar pill) or trials with no treatment, but with the exception of one poor-quality controlled trial with placebo, none were found. Trials comparing antibiotics with other treatments were not included.

Results

Twenty-two studies (a total of 3215 participants) were included in the review. Most of the studies involved people with mild to moderate CDI infection who were able to take oral antibiotics. Sixteen of the included studies excluded participants with severe infection, and few participants with severe infection were included in other studies. Twelve different antibiotics were evaluated. Most studies have compared vancomycin or metronidazole with other antibiotics. One small study compared vancomycin to a placebo (such as a sugar pill). There were no other studies comparing antibiotic treatment with placebo or no treatment. The quality of seventeen of the 22 studies was questionable. Four studies found that vancomycin was superior to metronidazole in achieving sustained symptomatic relief (defined as resolution of diarrhea without recurrence of infection). We rated the quality of the evidence supporting this conclusion as moderate. A new antibiotic, fidaxomicin, outperformed vancomycin in two large trials. We rated the quality of the evidence supporting this conclusion as moderate. It is worth noting that the difference in efficacy between these antibiotics was not too great, and that metronidazole is less expensive than both vancomycin and fidaxomicin. A pooled analysis of two small studies suggested that teicoplanin may be superior to vancomycin in achieving symptomatic relief. The quality of the evidence supporting this conclusion is very low. The quality of the evidence for the other seven antibiotics in this review is very low. studies were small and many patients left before completion. One hundred and four deaths were reported during the studies, all attributed to pre-existing health problems in the patients. The only side effects attributed to the antibiotics were occasional nausea and a temporary increase in liver enzymes. The latest cost data (July 2016) shows that the cost – the cost of a 10-day course of treatment with metronidazole 500 mg, as the least expensive antibiotic, will be 13 US dollars. The cost of vancomycin 125 mg will be 1779US$, compared to US$3,453.83 or more for fidaxomicin 200mg and approximately US$83.67 for teicoplanin.

Conclusions most studies excluded patients with a severe form. Due to the lack of studies with “no treatment” control groups, it is not possible to conclude that antibiotics should be used in patients with moderate infection after stopping the antibiotic that caused the infection. However, moderate-quality evidence suggests that vancomycin is superior to metronidazole and fidaxomicin is superior to vancomycin. The difference in the effectiveness of these antibiotics was small, and the advantage of metronidazole is that its price is much lower than the price of other antibiotics. The quality of evidence for teicoplanin was very low. Larger studies are needed to determine if teicoplanin works as well as other antibiotics. It would be interesting to conduct a clinical trial comparing the two cheapest antibiotics, metronidazole and teicoplanin.

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Translation notes:

Translation: Nefedova Darya Dmitrievna. Editing: Ziganshina Lilia Evgenievna. Project coordination for translation into Russian: Cochrane Russia – Cochrane Russia (branch of the Northern Cochrane Center on the basis of Kazan Federal University). For questions related to this translation, please contact us at: [email protected]; [email protected]

Antibiotics for angina: which antibiotic is better for angina or tonsillitis

Angina is caused by a viral or bacterial infection. Antibiotics are given when a sore throat is thought to be caused by the latter type of infection, as they can relieve symptoms and prevent complications. Questions such as: a certain type of antibiotic, its dosage, timing and time of use – the doctor, as a rule, selects for each patient purely individually, taking into account all the characteristics of his body. In this article, we will give you general information about angina, what kind of disease it is, and what antibiotics to drink for angina.

Angina is an infectious disease characterized by acute inflammation of the palatine tonsils and mucous membranes caused by infection or irritants such as viruses, fungi or bacteria.

With such a trouble as tonsillitis, antibiotic treatment should be correctly selected and carried out even at the very first symptoms. In addition to viral and bacterial, there are several more types of angina:

• Lacunar angina
• Catarrhal angina
• Follicular (purulent) tonsillitis

Viral and bacterial angina

Contrary to popular belief, this disease is most often caused by viruses, only about 10 – 15% of angina in adults have a bacterial etiology (even less often fungal) and require antibiotic treatment.

A sore throat of bacterial etiology (most often caused by streptococci) is characterized by a rapid onset of symptoms. Both the pharynx and the palatine tonsils are susceptible to inflammation, on which characteristic white or greenish-yellow plaques appear. This results in a very severe sore throat that often makes it difficult to swallow solid foods. Unlike viral pharyngitis, with bacterial angina, there is almost always a fever (temperature over 38 ° C), which sometimes even reaches 40 ° C and chills. Cough and runny nose are usually absent. Very often there is also an increase in the submandibular and cervical lymph nodes.

How is bacterial tonsillitis treated?

In case of symptoms characteristic of a bacterial infection, it is necessary to consult a general practitioner who, after examination, will most likely prescribe an antibiotic for purulent sore throat. Taking antibiotics to treat this particular disease is only possible with a doctor’s prescription, we strongly advise against buying antibiotics for sore throat without a prescription. You can get an electronic prescription for an antibiotic from a doctor in a few clicks using the Doc.ua service. A poorly chosen antibiotic or an inadequate dose will not work and may cause side effects. In addition to antibiotics, you should also take probiotics, pain and fever medications (ibuprofen or paracetamol), and sore throats (just like you would treat viral pharyngitis). Cold compresses on the forehead and neck can help fight fever, as well as proper hydration by drinking water, raspberry juice, or lemon tea.

Which antibiotic to drink for angina

Antibiotics for angina are quite serious drugs that are best taken after being prescribed by a doctor on an individual basis.

Practice has long shown that with what antibiotics to treat a sore throat, in such terms it will pass. Often patients make the mistake of stopping their medications immediately after all acute symptoms have disappeared. However, even regardless of what antibiotics you were prescribed for angina, strong or weak, the entire antibiotic course must be completed.

Also, tonsillitis should be treated with antibiotics as soon as the first symptoms appear. In no case should you start such a disease and put off its treatment indefinitely.

Do I need to take antibiotics for angina

Do I need to treat angina with antibiotics? Yes, bacterial or purulent sore throats need to be treated with antibiotics, but some people try to avoid these drugs because of their fear of them. People who are somehow afraid of antibiotics can be roughly divided into two large groups:

• Those who are afraid of their negative impact on the body.
• Those who had an unpleasant experience when they independently decided which antibiotics to take for angina, or when the doctor, for the sake of his own reinsurance, prescribed strong drugs, in the case when it was completely possible to do without them.

However, every adult should also be aware of the fact that antibiotics for angina for adults are necessary drugs for treatment, so you need to know which antibiotics to treat angina for an adult, and which antibiotics to treat angina for a child.

How long do antibiotics help with angina

How quickly do antibiotics help with angina? Once a person with bacterial angina starts taking antibiotics, they are expected to have a significant improvement in their symptoms within the first 24 to 72 hours. What day do antibiotics help with angina? On average, with antibiotic treatment, recovery can take three to five days. And if symptoms are still present at the end of this period, the patient will be asked to return for a reassessment.

Antibiotic for angina in children

Angina in children is a very common disease that requires a special approach to treatment. Most often, for treatment, the doctor also prescribes an antibiotic for purulent tonsillitis in children. However, not all antibiotics can be taken by children, only a doctor can determine how an antibiotic can be taken for angina in children.

If the suspected cause of tonsillitis is a virus, the doctor will not prescribe antibiotics, then the strategies we list below are the only treatment for tonsillitis in children. Your child will likely get better within seven to ten days.

Home care strategies to use during treatment for sore throat in children include the following:

• Encourage rest. Encourage your child to sleep a lot.
• Provide sufficient fluid. Give your child plenty of water to keep their throat moist and prevent dehydration.
• Salt water rinse. Gargling with salt water will help soothe a sore throat. Have your child gargle with the solution and then spit it out.
• Give your child lozenges for a sore throat.
• Humidify the air. Use a cold air humidifier to remove dry air that can further irritate a sore throat.