What are probiotics and why does my doctor recommend taking them after antibiotics?
  • The “pro” in “probiotics” means good, so probiotics are the “good bacteria”. Our gut normally contains a population of good bacteria. They help with digestion and help with protecting our gut from the bad bacteria that cause infections.
  • When we get sick, we are often prescribed antibiotics. Antibiotics are used to kill the bad bacteria that is causing us to feel sick, but it can kill the good bacteria, too. This is why antibiotics can cause stomach upset and/or diarrhea. It takes a while for the good bacteria to grow back, so your doctor or pharmacist may recommend taking probiotics when you are done taking antibiotics.
Who should take probiotics?
  • Unfortunately, probiotics are not well studied. In recent years, researchers have taken interest in the vast opportunities for its use, but right now there is still not much evidence that says who would benefit.
  • There is some evidence and recommendations for use in certain situations. Here’s a few:
    • Decreases the risk of diarrhea after antibiotic use.
    • Improves stool consistency and prevent constipation.
    • Prevent flare-ups in adults with ulcerative colitis.
    • Improves stomach pain and other symptoms of irritable bowel syndrome.
    • Prevent a rare but serious condition (necrotizing enterocolitis) that is seen in premature infants.
There are a lot of products out there, but which ones should I choose?
  • Many fermented products already have a small amount of probiotics. This is because to kickstart the fermenting processes, a dash of bacteria was added in. This includes yogurt, kombucha, sauerkraut, kimchi and miso. Regular consumption of these everyday probiotic foods can be beneficial, but the specific benefits or the extent of those benefits remain unclear.
  • In order to be an effective probiotic, the supplement needs to be an active live culture. Look for this on the packaging. Similar to how we hear about bad bacteria, such as coli or Staph, probiotics also have names. When you are looking for probiotics, look at the label and see what it contains.
  • The most common names to look for are:
    • Lactobacillus
    • Bifidobacterium
    • Saccharomyces boulardii (yeast)
  • Some products we recommend:
    • Activia yogurt
    • Yakult drink
    • Florastor capsules, sachets
    • Align capsules
    • VSL #3 capsules, sachets
  • Depending on what you are using probiotics for, the recommendation may change. We recommend speaking with your doctor or pharmacist about this.
  • Keep in mind that many probiotic drinks or yogurts contain a lot of sugar!
Problems with probiotics
  • Most probiotics are sold as supplements and do not need to be approved by the FDA. Since they are not strictly regulated by the FDA, what the label says is in the product may not be in the product at all. This is especially concerning since probiotics are often on the pricier side. Sometimes companies/manufacturers will go the extra mile and have their products double checked. To ensure you are getting what the label says you are, be sure to look for these symbols:

Takeaways
  • Probiotics are beneficial in certain situations. That being said, it is safe for overall healthy people to take regularly and can help with overall gut health.
  • They can be pricy! Make sure to check the label to ensure you are getting what you pay for. After that, feel free to pick what fits your budget! Pricy does not always equal better!
  • If you are ever unsure, ask your provider or a pharmacist if probiotics may be good for you!

Prepared by Gabrielle Kim PharmD Candidate 2022