Ask Pharmaca: Which Post-Antibiotic Probiotic Should I Take?

Q. I’m taking an antibiotic and my doctor said I should be on a probiotic too. What do you recommend?

A. The purpose of an antibiotic is to kill harmful bacteria. But antibiotics are not selective in the killing process—good gut bacteria (i.e. your intestinal flora) is often wiped out along with bad bacteria. This process can have a variety of side effects, including antibiotic-associated diarrhea (AAD), candida overgrowth and decreased immunity. In fact, it can take a year or longer to repair healthy gut flora after just one round of antibiotics.

To minimize side effects and keep your intestinal tract healthy, it is highly recommended to take probiotics after (or even during) a course of antibiotics. While probiotics are a good foundational supplement to take year round, here are some specific antibiotic recommendations:

An antibiotic-specific formula that has been clinically proven to help when taken concurrently with antibiotics.

Pharmax HLC Antibiotic Care – Clinically proven to supplement normal intestinal microbiota following antibiotic therapy; includes FOS for probiotics to feed on and grow strength from.

A formula featuring Saccharomyces boulardii (aka S. boulardii or Sac B), a strain of beneficial yeast—not bacteria—that antibiotics cannot damage. It’s also naturally resistant to the harsh environment of stomach acid. Sac b stimulates the body’s immune response and fortifies the protective barrier in the digestive tract.

Thorne Research Sacro-B – Supports beneficial intestinal flora and is helpful for occasional diarrhea.

Jarrow Formulas Saccharomyces Boulardii + MOS – Restores natural intestinal microflora, while MOS discourages unfriendly bacteria from adhering to stomach lining.

Renew Life Ultimate Flora Advanced Immunity – Combines Saccharomyces boulardii with two other specialized immune boosters to promote a balanced immune system and enhance the body’s defenses throughout the year.

A comprehensive formula featuring both a high probiotic count (i.e. more than 25 billion CFU) and a strong variety of Lactobacillus and Bifido probiotic strains to ensure bacteria in both the upper and lower intestines are replaced. (As a general rule of thumb, Lactobacillus strains live in the small intestine, whereas Bifido strains live in the large intestine/colon).

Renew Life Ultimate Flora Critical Care 50 Billion – A high-potency, 50 Billion CFU, 10-strain Lactobacillus and Bifido variety. Increasingly popular soil-based probiotics, which are stable without needing special coatings or preservatives, and are naturally resistant to the harsh environment of the upper digestive tract and stomach.

Garden of Life Primal Defense – This soil-based, 12-strain probiotic is formulated to survive the toughest digestive environments undeterred by stomach acid and bile salts.

It’s good to note that multiple rounds of antibiotics, current gut sensitivity or prior negative side effects from antibiotics (e.g. AAD) suggest a more potent or comprehensive probiotic formula for increased protection. In addition, if you have sensitivities to dairy or wheat, make sure to check the product ingredients, as many probiotic formulas contain one or both. Look to brands like Pharmax or Renew Life for 100% dairy- and wheat-free formulas. And to ensure top benefits from both your probiotics and antibiotics, always take them at least two hours apart from each other.