Should you take probiotics with antibiotics. How do probiotics affect gut health during antibiotic treatment. What does research say about combining probiotics and antibiotics. Are there risks to taking probiotics with antibiotics. How long does it take for gut microbiome to recover after antibiotics.

The Debate on Combining Probiotics and Antibiotics

The question of whether to take probiotics alongside antibiotics has sparked considerable debate in the medical community. While some studies suggest potential benefits, others raise concerns about long-term effects on gut health. This complex issue lacks a straightforward answer, as research findings have been mixed.

Antibiotics are essential for treating bacterial infections, but they can disrupt the delicate balance of beneficial bacteria in our digestive system. Probiotics, containing live microorganisms, are often proposed as a way to mitigate these effects. However, their efficacy and safety when used concurrently with antibiotics remain subjects of ongoing research.

Evidence Supporting Probiotic Use During Antibiotic Treatment

Several studies have indicated potential benefits of taking probiotics alongside antibiotics, particularly in reducing the risk of antibiotic-associated diarrhea (AAD).

Cochrane Review Findings

A comprehensive Cochrane review analyzed 23 studies involving 3,938 participants, focusing on various probiotic strains including Bacillus spp., Bifidobacterium spp., Lactobacilli spp., and Saccharomyces spp. The review reported a significant reduction in AAD incidence among those taking probiotics:

• 8% in the probiotic group experienced AAD
• 19% in the control group experienced AAD
• The relative risk was 0.46 (95% CI 0.35 to 0.61)
• The number needed to treat (NNT) was 10

Based on these findings, the authors suggested that Lactobacillus rhamnosus or Saccharomyces boulardii at 5 to 40 billion colony-forming units per day could be appropriate choices for preventing AAD in children.

Safety Considerations

The review noted that no serious adverse events were observed in healthy children. However, caution is advised for severely debilitated or immunocompromised children, as serious adverse events have been reported in these populations. Further research is needed to establish safety guidelines for at-risk pediatric groups.

Arguments Against Concurrent Probiotic and Antibiotic Use

Despite the positive findings in some studies, other research has raised concerns about the long-term effects of probiotic use during antibiotic treatment.

The Weizmann Institute Study

A 2019 study from the Weizmann Institute of Science in Israel challenged the conventional wisdom of taking probiotics after antibiotics. The researchers found that:

• Participants given an 11-strain probiotic treatment for four weeks following antibiotics experienced a delayed return to normal gut microbiome composition
• The probiotic group’s gut microbiome took six months to return to its normal state
• Those not given probiotics saw their gut microbiome return to normal within three weeks

These findings suggest that while probiotics may colonize the gut with healthy bacteria, they might also interfere with the natural recovery process of the gut microbiome following antibiotic treatment.

The Gut Microbiome: A Complex Ecosystem

To understand the impact of antibiotics and probiotics on our health, it’s crucial to grasp the concept of the gut microbiome.

What is the Gut Microbiome?

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

• Digestion and nutrient absorption
• Immune system regulation
• Production of certain vitamins
• Protection against harmful pathogens
• Influence on mental health through the gut-brain axis

While the composition of the gut microbiome is largely determined by genetics, it can be influenced by factors such as diet, lifestyle, and medication use – particularly antibiotics.

The Impact of Antibiotics on Gut Health

Antibiotics are indispensable in treating bacterial infections, but their use comes with potential consequences for gut health.

How Do Antibiotics Affect the Gut Microbiome?

Antibiotics work by killing or inhibiting the growth of bacteria. However, they often cannot distinguish between harmful pathogens and beneficial bacteria in our gut. As a result, antibiotic treatment can lead to:

• Reduced diversity of gut bacteria
• Disruption of the balance between different bacterial species
• Increased susceptibility to opportunistic infections
• Temporary changes in digestive function

These effects can manifest as side effects such as diarrhea, nausea, and abdominal discomfort. In some cases, the disruption of the gut microbiome can lead to more severe complications like Clostridioides difficile (C. diff) infection.

Potential Benefits of Probiotics During Antibiotic Treatment

Proponents of using probiotics alongside antibiotics argue that these beneficial microorganisms can help mitigate some of the negative effects on gut health.

How Might Probiotics Help?

The potential benefits of taking probiotics during antibiotic treatment include:

1. Reducing the risk of antibiotic-associated diarrhea
2. Maintaining a more balanced gut microbiome during treatment
3. Potentially lowering the risk of opportunistic infections
4. Supporting immune function
5. Possibly reducing other gastrointestinal side effects of antibiotics

These potential benefits are supported by studies like the Cochrane review mentioned earlier, which found a significant reduction in AAD among children taking probiotics.

Risks and Side Effects of Probiotic Use

While probiotics are generally considered safe for most people, they can cause side effects in some individuals, particularly when taken in large doses or by those with compromised immune systems.

Common Side Effects of Probiotics

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

• Abdominal bloating and pain
• Gas and flatulence
• Nausea
• Vomiting
• Constipation
• Increased phlegm production
• Chest pain
• Skin rash
• Changes in appetite
• Taste disturbances

These side effects are generally mild and transient. However, individuals with underlying health conditions or weakened immune systems should consult their healthcare provider before starting probiotic supplementation.

Alternative Approaches to Supporting Gut Health

Given the conflicting evidence on probiotic use during antibiotic treatment, researchers are exploring alternative methods to support gut health and microbiome recovery.

Fermented Foods

Naturally fermented foods like sauerkraut, kimchi, kefir, and yogurt contain beneficial bacteria that may support gut health. These foods offer a more diverse range of microorganisms compared to many probiotic supplements and may provide additional nutritional benefits.

Autologous Fecal Transplantation

A novel approach being studied is autologous fecal transplantation. This involves:

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

Studies have shown promising results with this method, with the gut microbiome returning to normal within eight days post-transplantation, compared to 21 days for those who didn’t undergo the procedure. However, this approach is currently only approved for treating recurrent C. difficile infections.

Factors to Consider When Deciding on Probiotic Use

The decision to use probiotics alongside antibiotics should be made on an individual basis, considering various factors:

Personal Health Status

Individuals with compromised immune systems, chronic illnesses, or a history of severe gastrointestinal issues should consult their healthcare provider before using probiotics.

Type of Antibiotic

Different antibiotics have varying effects on the gut microbiome. The potential benefits of probiotic use may depend on the specific antibiotic being used.

Probiotic Strain Selection

Not all probiotics are created equal. Different strains have different effects and may be more or less beneficial depending on the individual and the condition being addressed.

Timing of Probiotic Administration

Some healthcare providers recommend taking probiotics a few hours apart from antibiotics to minimize direct interaction between the two.

Duration of Use

Consider whether short-term probiotic use during antibiotic treatment or continued use after completing the course is more appropriate for your situation.

The Need for Further Research

The conflicting evidence surrounding probiotic use with antibiotics highlights the need for more comprehensive research in this area.

Areas for Future Study

Future research should focus on:

• Long-term effects of probiotic use during antibiotic treatment
• Identifying specific probiotic strains that are most beneficial for different antibiotics and conditions
• Optimal timing and duration of probiotic supplementation
• Comparative studies between probiotic supplements and fermented foods
• Safety and efficacy of probiotics in diverse patient populations

As our understanding of the gut microbiome continues to evolve, so too will our approaches to supporting gut health during and after antibiotic treatment.

Practical Recommendations for Patients

While the debate on probiotic use during antibiotic treatment continues, there are several practical steps patients can take to support their gut health:

Consult Your Healthcare Provider

Before starting any probiotic regimen, especially during antibiotic treatment, consult with your healthcare provider. They can offer personalized advice based on your medical history and current health status.

Follow Antibiotic Instructions Carefully

Take antibiotics exactly as prescribed, completing the full course even if you start feeling better. This helps ensure the infection is fully treated and reduces the risk of antibiotic resistance.

Consider Dietary Changes

During and after antibiotic treatment, focus on a diet rich in fiber and fermented foods. These can help support the growth of beneficial gut bacteria naturally.

Stay Hydrated

Drinking plenty of water can help mitigate some gastrointestinal side effects of antibiotics and support overall health.

Monitor Your Symptoms

Pay attention to any changes in your digestive health during and after antibiotic treatment. Report persistent or severe symptoms to your healthcare provider promptly.

Conclusion: A Balanced Approach to Gut Health

The question of whether to take probiotics with antibiotics remains complex, with valid arguments on both sides. While some studies suggest potential benefits in reducing antibiotic-associated diarrhea, others raise concerns about delayed microbiome recovery.

As research continues to evolve, a balanced approach involves considering individual health factors, consulting with healthcare providers, and potentially exploring alternative methods to support gut health. The goal is to maximize the benefits of antibiotic treatment while minimizing its impact on the gut microbiome.

Ultimately, maintaining a healthy lifestyle, including a balanced diet rich in fiber and fermented foods, may be the most sustainable way to support long-term gut health. As our understanding of the gut microbiome grows, so too will our strategies for protecting and nurturing this crucial aspect of our overall health.

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]

instructions for use and a list of diseases that can be treated

Are you interested in how to use Bicilin 5? In the article you will find detailed instructions for using the medicine, as well as information on which diseases Bicilin 5 can be used for and what effect to expect.

Bicilin5 is an antibiotic used to treat various bacterial infections. The drug has a wide spectrum of action and can be used to treat several diseases.

This instruction is intended for those who have encountered a certain disease and decided to use Bicilin5. In the article, we will consider in detail why this drug is recommended, how to use it according to dosage, and in what cases it should be abandoned.

If you want to know how to use Bicilin5 for the treatment of diseases such as tonsillitis, scarlet fever, syphilis, leprosy or other infectious diseases, read on.

Bicilin5: what is it?

Bicilin5 is a drug used to treat infectious diseases.

The drug contains five isomers of benzylpenicillin, which are excreted from the body in turn, providing a long-term therapeutic effect.

Bicilin5 is one of the most common antibiotics used to treat a number of infectious diseases such as tetanus, rheumatism, scarlet fever, respiratory diseases, and other bacterial infections.

Note: Always consult your doctor before using this medicine.

Indications for use Bicilin5

Bicilin5 is a drug used as an antibacterial drug. It is used to treat a number of bacterial infections. Its indications include:

• Scarlet fever: it is often used to treat infections that cause prolonged sore throat.
• Streptococcal tonsillitis: it is effective in the treatment of streptococcal tonsillitis, which causes sore throat and fever.
• Pneumonia: it can also be used to treat pneumonia caused by a bacterial infection.

In general, Bicilin5 is a universal drug for the treatment of bacterial infections. Before starting treatment with Bicilin5, it is always necessary to consult a doctor and follow his recommendations for dosage and duration of use.

How to use Bicilin5?

Bicilin5 is a drug often used to treat staphylococcus and streptococcus infections, which can cause many different illnesses.

The drug can be used to treat diseases such as rheumatic fever, pneumonia, sepsis, infective endocarditis and others. In addition, Bicilin5 can be used to prevent rheumatic fever in children.

Instructions for use Bicilin5 may vary depending on the disease and the patient. Usually the drug is administered intramuscularly, in a dosage that depends on the weight of the patient.

1. A course of 10 injections given every 21 days is used to treat rheumatic fever in children.
2. For the treatment of infective endocarditis, a course of 4-6 injections every 5-7 days is used.

When using Bicilin5, it is necessary to perform blood tests to determine the effectiveness of treatment and monitor possible side effects.

Indications for use Dosing schedule

90 103 Injections 1–2 days later

Despite Although Bicilin5 is an effective drug, its use can cause side effects such as allergic reactions and impaired kidney function. Therefore, before you start using the drug, you should consult with an infectious disease specialist and read the instructions for use.

Contraindications

Although Bicilin5 is considered to be a fairly safe and effective drug, some people may have contraindications to its use. For example:

• Allergic reaction to the components of the drug. If the patient was allergic to any other antibiotic from the penicillin group, the doctor should prescribe another remedy.
• Serious liver or kidney disease. Such patients may have difficulty metabolizing drugs, which increases the risk of complications.
• Pregnancy and breastfeeding. During pregnancy, the drug can be used only for health reasons and under medical supervision. Bicilin5 components can penetrate into breast milk, so it is not recommended to use it during breastfeeding.

Before starting a course of treatment, it is necessary to undergo an examination and consultation with a doctor who will take into account all the patient’s chronic diseases and age-related features. In this case, the risk of complications will be minimal, and the treatment will bring maximum benefit.

Special instructions

When using Bicilin5, the following special instructions should be taken into account:

• This drug is not recommended for use in patients with hypersensitivity to penicillin, thiopenic acid or other similar drugs.
• Adjust dosage carefully when treating patients with kidney or liver disease or who have a history of allergic reactions to antibiotics.
• With prolonged use, it is necessary to regularly monitor the function of the kidneys and liver.
• The combined use of Bicilin5 with digitalis, aminoglycosides or warfarin requires constant monitoring of the therapeutic effect.
• It is not recommended to prescribe Bicilin5 simultaneously with other antibiotics for the prevention of tuberculosis.

Please note! These special instructions are not exhaustive and additional specialist advice may be required before starting treatment with Bicilin5.

Unusual effects from Bicilin5

Bicilin5 is a medicine for the treatment of infections caused by bacteria. However, in addition to the main action, it can also have unusual effects.

• Allergic reactions: after using Bicilin5, some patients may experience an allergic reaction, which manifests itself in the form of itching, urticaria, swelling, loss of consciousness and even anaphylactic shock.
• Fever: Some patients may experience an increase in body temperature after using Bicilin5. This may be due to the body’s reaction to the drug.
• Blood pressure problems: Some patients may experience changes in blood pressure after using Bicilin5. Both an increase and a decrease can be observed.
• Digestive problems: Some patients may experience digestive problems such as nausea, vomiting, diarrhea or constipation after using Bicilin5.

If you notice unusual effects after using Bicilin5, you should immediately consult a doctor. Also, be sure to tell your doctor about all medications you are taking, as well as any allergic reactions you have ever experienced.

Bicilin5 disease regimens

Tuberculosis treatment

Bicilin5 is a drug often used to treat tuberculosis. The treatment regimen usually includes injections of Bicilin5 for the first 2 months, then they switch to injections of Bicilin3. Treatment continues for 6-9 months of total duration.

Bicilin 5 injections are usually given once a week and the dosage depends on the weight of the patient. It is important to monitor the regularity of taking the medicine, since its interruption can lead to the disappearance of tuberculosis bacteria and exacerbation of the disease.

Treatment of leprosy

Bicilin5 can also be used to treat leprosy. Treatment involves injecting medication into the patient’s thigh muscle. The treatment regimen in the first year includes injections every 4 weeks, and the second year – once every 8 weeks.

As in the treatment of tuberculosis, it is important to monitor the regularity of taking the medicine, as its interruption can lead to an aggravation of the disease.

Treatment of other diseases

Bicilin5 can also be used in the treatment of other infectious diseases, such as syphilis. However, the treatment regimen in such cases may differ and should be prescribed by a doctor.

It is important to remember that the use of Bicilin5 should only be carried out under the direction of a doctor and under his supervision, as improper use can lead to serious health consequences.

Bicilin5 in the treatment of tuberculosis

Bicilin5 is one of the most common and effective drugs used to treat tuberculosis. It is a mixture of five penicillin salts, which is used as an injection.

Bicilin5 is the first line of drugs used to treat tuberculosis. It allows you to kill the bacteria that cause the disease and prevent its spread.

In order to get the maximum benefit from treatment with Bicilin5, you must follow the instructions for use exactly and take the drug regularly. If treatment is stopped, tuberculosis may return and become even more difficult to treat.

In general, bicillin5 is a safe and effective drug for the treatment of tuberculosis. However, like any drug, it can have side effects that must be taken into account during treatment.

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Q&A:

What diseases does Bicilin5 treat?

Bicilin5 is used to treat diseases such as bronchitis, pneumonia, as well as rheumatic fever and other infectious diseases caused by streptococci.

In what form is Bicilin5 produced?

Bicilin5 is available as a powder for solution that is injected into the muscle. The solution is prepared before each administration and should be used immediately after preparation.

How often should Bicilin5 be administered in the treatment of rheumatic fever?

In the treatment of rheumatic fever, Bicilin5 is usually administered once a week, the duration of the course depends on the stage and severity of the disease and is prescribed by the doctor individually.

Can Bicilin5 be used during pregnancy?

Bicilin5 can be used during pregnancy only on prescription and in case of emergency, when the benefit outweighs the potential risk to the fetus.

What are the side effects of using Bicilin5?

When using Bicilin5, various side effects may occur – from mild reactions at the injection site (pain, swelling, redness) to allergic reactions such as urticaria, Quincke’s edema, angioedema. If any unwanted symptoms appear, you should immediately consult a doctor.

Can Bicilin5 be used to prevent rheumatic fever?

Bicilin5 can only be used to prevent rheumatic fever in people who already have the disease. For people who do not have rheumatic fever, its use is inappropriate and can harm the body.

Bicilin5 in the treatment of rheumatism

Many patients diagnosed with rheumatism find it necessary to use antibiotics to fight streptococcal infection. In such cases, Bicilin5 is just used – a remedy containing benzylpenicillin in its composition.

This drug is one of the most popular and effective in the treatment of rheumatism. It has a fairly powerful anti-inflammatory and antimicrobial effect, which helps to effectively fight infection and reduce inflammation in the body.

• It is important to consider that in the treatment of rheumatism, the use of Bicilin5 is carried out exactly in accordance with the instructions that the doctor must draw up.
• The drug is usually administered intramuscularly and the dosage depends on the patient’s age and weight, as well as the severity of the disease. To achieve the maximum effect, it is often necessary to conduct several courses of treatment.

Thus, Bicilin5 is one of the most popular and effective drugs in the treatment of rheumatism. With the correct use of this tool, you can achieve good results in the fight against infection, as well as reduce inflammation in the body.

Prevention of rheumatism with Bicilin5

Rheumatism is a serious disease that affects the connective tissue and can lead to heart failure, chronic joint pain and other consequences. One of the effective ways to prevent rheumatism in children and adults is the use of Bicilin5.

Bicilin5 is an antibiotic that contains five doses of cefazolin, prevents the development of infectious bacteria and inflammation of the connective tissue. A course of preventive therapy using this drug eliminates the possibility of developing rheumatism, even in the presence of infectious diseases that can provoke the onset of this disease.

Rheumatism can result not only from unfortunate infectious diseases, but also from disorders of the immune system. Bicilin5 helps prevent the development of rheumatic processes, reduces the likelihood of the formation of yellow wings on the heart valves, and prevents damage to the connective tissue.

The use of Bicilin5 does not lead to the development of side effects, since this tool is a development of specialists and has passed all the necessary clinical trials. It is important to know that it is recommended to take a course of prophylactic therapy with this drug every 6-12 months, depending on the doctor’s prescription.