Your gut-friendly guide to taking antibiotics

Did you know around 36 million antibiotics are prescribed every year in the UK?[sup]1[/sup]

Antibiotics save countless lives by effectively treating bacterial infections, either killing bacteria or stopping their spread.[sup]2[/sup] They're a powerful tool, but they don't come without challenges—one of which is their impact on your gut health. Antibiotics can disrupt the natural balance of healthy gut bacteria, leading to unwanted side effects, such as Antibiotic-Associated Diarrhea (AAD).[sup]3[/sup]

What is AAD?

Have you ever felt “off” or noticed digestive issues while on antibiotics? You’re not alone. Up to 1 in 3 people experience antibiotic-associated diarrhoea (AAD).[sup]4[/sup] AAD refers to diarrhoea that develops as a side effect of taking antibiotics. It can range from mild symptoms, like loose stools, to more uncomfortable symptoms including cramps and frequent trips to the bathroom. The likelihood of experiencing AAD depends on several factors, including the type of antibiotic prescribed, the dose and your general health.

What causes AAD?

Antibiotics work by targeting bacteria that cause infections, but they can’t differentiate between ‘good’ and ‘bad’ bacteria living in your gut, meaning they can disrupt the overall natural balance of your gut microbiome.[sup]5[/sup] In doing so, notorious bacteria, for example Clostridium difficile (commonly called C. diff), can grow out of control, if left unchecked.²

Certain antibiotics, like erythromycin, can also cause diarrhoea by speeding up the movement of food through your gut. Occasionally, an allergic reaction to the antibiotic can be the cause of AAD.[sup]6[/sup]

How does AAD affect people?

AAD can affect both children and adults, impacting overall health and well-being, with key complaints including[sup]1,7[/sup]

• A reduced quality of life
• Sick days off work
• Stopping antibiotic treatment too early, leading to failed treatment and antibiotic resistance

• Additional digestive symptoms such as bloating, taste disturbances and nausea

AAD typically starts 5 days after antibiotic therapy starts, and can last between 2 to 41 days[sup]8[/sup]

But the good news is that, research has shown that specific live bacterial supplements (also known as probiotics) can help reduce symptoms of AAD during a course of antibiotics.[sup]9[/sup]

Should you take a live bacterial supplement with antibiotics?

Research suggests that using a live bacterial supplement alongside antibiotics can protect and/or restore your gut microbiome.⁹ By maintaining bacterial diversity, live bacterial supplements can significantly reduce disruptions caused by antibiotics, including symptoms like AAD.[sup]10[/sup]

The World Gastroenterology Organisation (WGO) global guidelines on probiotics and other leading Paediatric guidelines recommend a specific type of bacteria (known as a strain) for children and adults taking antibiotics[sup]11,12[/sup]. They advise taking the world’s most studied Lactobacillus strain, Lactobacillus rhamnosus, LGG®, alongside your antibiotic treatment. That’s because it’s been scientifically proven to reduce the risk of developing AAD by more than two thirds, and its duration by more than a day, when compared to not taking LGG®, in both children and adults.[sup]7,13-14[/sup] It’s worth being aware that not all live bacterial supplements are created equal, and it’s important to take the right strain, at the right time, in the right way.

How and when should you take a live bacterial supplement?

To get the most out of your antibiotics and live bacterial supplements:

• Follow the instructions on your antibiotic prescription or consult your healthcare provider for guidance. Always finish the full course of antibiotics.

• Start taking a live bacterial supplement containing Lactobacillus rhamnosus LGG® on the first day of your antibiotic course, or as soon as possible afterwards.
• The WGO guidelines recommend a daily dose of 20 billion Lactobacillus rhamnosus, LGG®, ideally taken as 10 billion twice per day.[sup]11[/sup]

• Continue taking the live bacterial supplement daily throughout the antibiotic treatment and for at least 7 days after finishing the course.

• After finishing your antibiotics, aim to slowly increase the number of different plants in your diet to help ‘re-fertilise’ your gut microbiome. Aim to include something from the Super Six plant groups in your diet each day - vegetables, wholegrains, fruit, legumes (beans and pulses), nuts and seeds, and herbs and spices.

The science is clear—taking a live bacterial supplement alongside antibiotics can be a powerful way to reduce their negative effects on your gut microbiome. But it’s important to choose a scientifically proven bacterial strain, such as Lactobacillus rhamnosus, LGG®, and to consult your healthcare provider if you have any concerns.