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Using probiotics during antibiotic therapy

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Q: My child has developed a bacterial infection, and my family doctor has recommended a course of antibiotics. Is there anything I can do to offset any harmful effects of this on my child’s digestive system?

A: Antibiotic therapy was one of the most important medical breakthroughs of the 20th century. More recently, the appropriate use of antibiotics has become a contentious point within the medical community, especially given the emergence of antibiotic-resistant strains of bacteria such as MRSA (methicillin-resistant Staphylococcus aureus) and others.

Antibiotic therapy in children has been associated with disruptions in the balance of gut microbiota, which may lead to long-term medical problems, including irritable bowel syndrome, autoimmune conditions, and obesity. A recent study suggests that up to 70 percent of infants receive a course of antibiotics within the first year of life, so finding ways to mitigate these effects is important.

Probiotic supplementation has been shown to reduce the disruption of intestinal bacterial species induced by antibiotics. A recent study found that supplementation with Lactobacillus rhamnosus GG might reduce some of the changes in gut flora induced by penicillin. In a total of 88 children given penicillin, the probiotic treatment prevented the penicillin-associated increase of Clostridium bacterium species.

Another study found that adding Saccharomyces boulardii probiotic supplementation to amoxicillin-clavulanate antibiotic treatment in adults led to “less pronounced microbiota shifts including less overgrowth of Escherichia and to a reduction in antibiotic-associated diarrhea scores.”

In studies of adults treated with antibiotics for Helicobacter pylori infection, supplementation with probiotics alongside antibiotic therapy mitigated the disruptive effects of the antibiotics on the diversity and species of gut microbiota.

Given their high safety and potential benefit, probiotics deserve strong consideration as therapy alongside antibiotics.

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