According to a study by researchers at Albert Einstein College of Medicine published in American Family Physician, one in five people on antibiotics stops taking his or her full course of antibiotic therapy due to diarrhea. It is the authors' belief that physicians could help patients avoid this problem by prescribing probiotics to be taken along with the antibiotics.
Antibiotics target “bad” bacteria but may also kill the “good” bacteria in the large intestine, leading to diarrhea. Of course, diarrhea can also result from bacterial and viral infections, but it is often caused by the antibiotics themselves.
Probiotics -- cultures of “good” microorganisms similar to those normally found in the gut ─ have been promoted as restoring the microbial balance disrupted by antibiotics and infections. Probiotic bacterial strains are added to certain yogurts and are also available as powders and pills sold in health food stores.
The authors reviewed the medical literature and found seven, high-quality studies in which probiotics were administered. In these studies, the researchers concluded that there is a good reason for the use of probiotics to avoid diarrhea resulting from antibiotic use or from gastrointestinal viral or bacterial infections. In addition, the probiotics used in these studies were found to rarely cause adverse effects, even in children.
“With the level of evidence that probiotics work and the large safety margins for them, we see no good reason not to prescribe probiotics when prescribing antibiotics,” says Dr. Benjamin Kligler, a co-author of the study and associate professor of clinical family and social medicine at Einstein. “The only drawback is that probiotics are not covered by health insurance.” On average, a one-month supply of probiotics costs between $8 and $22. (Side note: Isn't it interesting how valuable proactive healthcare products like these are not covered by insurance but the pharmaceutical products which simply treat symptoms are??)
Dr. Kligler notes that the effects of probiotic doses are short-lived, so they should be taken throughout a course of antibiotic therapy. The study says that probiotics will not diminish the effectiveness of antibiotics. Kligler adds that products vary widely in bacterial dose and in quality. The Einstein paper specifies several commercial probiotic preparations of sufficient strength to offer health benefits. In general, probiotic doses of more than 5 billion colony-forming units per day for children and more than 10 billion colony-forming units per day for adults were associated with the best outcomes.