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Einstein researchers recommend probiotics be routinely prescribed along with antibiotics – cite evidence they restore disrupted microbial balance

  [ 82 votes ]   [ 2 Comments ]
By Albert Einstein College of Medicine, Bronx, NY* • • January 3, 2009

"Our physicians.... are pretty good at regularly prescribing probiotics when they put a patient on antibiotics. But the average doctor is not doing this, and patients often know more about probiotics than their physicians do."

Up to one in five people on antibiotics stop taking their full course of antibiotic therapy due to diarrhea. Physicians could help patients avoid this problem by prescribing probiotics, according to a study by researchers at Albert Einstein College of Medicine published in the November 2008 issue of American Family Physician ("Probiotics" by Benjamin Kligler, MD, MPH, and Andreas Cohrssen, MD)

Antibiotics target "bad" bacteria but may also kill the "good" bacteria in the large intestine, leading to diarrhea. Diarrhea can also result from bacterial and viral infections. 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 brands of miso and other fermented foods, and are also available as powders and pills sold in health food stores.

The Einstein scientists reviewed the medical literature and found seven high-quality studies in which probiotics were administered to people.

• The researchers concluded that the studies support the use of probiotics for avoiding 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.

Dr. Kligler notes that:

• The effects of probiotic doses are short-lived, so they should be taken throughout a course of antibiotic therapy.

• Probiotics will not diminish the effectiveness of antibiotics, he adds.

Because probiotics are considered dietary supplements, they are not regulated as stringently as conventional foods and drugs. 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.

Dr. Kligler believes that physicians should be aware of specific brands so they can recommend only those known to be of quality….

"In our residency program, we've worked hard to train our physicians to consider probiotics as an option," says Dr. Kligler. "Now they are pretty good at regularly prescribing probiotics when they put a patient on antibiotics. But the average doctor is not doing this, and patients often know more about probiotics than their physicians do."

Dr. Kligler's co-author was Dr. Andreas Cohrssen, MD, director of the Beth Israel Medical Center Residency Program in Urban Family Practice. They have no financial ties to... the manufacturers of probiotics.

* Source: Modification of News release: "Researchers Find Convincing Evidence That Probiotics are Effective." Albert Einstein College of Medicine of Yeshiva University. December 17th 2008

Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat or cure any condition, illness, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.

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Article Comments Post a Comment

Posted by: bobichat2
Jan 21, 2009
Because of three separate infections, bronchitis two times and post-surgery antibiotics) all within 5 weeks, I suddenly developed severe stomach pains and then very bloody stool. Within a few hours I was rush by ambulance to the hospital and was started almost within 8 hours on Flagyl. Two days later I was out of pain and did not have bloody stools. I am very aware of most medical conditions and did us popular yogurts such as Activa and Stonyfield Farms for the duration of my antibiotic treatment. My gastrointerolagist informed me that the best yogurt is GREEK yogurt left out for hours on the counter to allow the bacteria to grow. I was hospitalized four days (in isolation after diagnosis) and have returned home now. My question is why is the public not informed via radio or television regarding the proper use of probiotics in order to at least ward of some of these terrible side effects ? I live in an over 62 community (I'm 67) and I know many count on the TV for most of their info. Also, why are primary care MD's not verballu informing patients of the best counter-measures to take to protect themselves?
Reply Reply

It's so important doctors should know this
Posted by: suemorr
Jan 29, 2009
My mother had c-diff and had a terrible time with it. Since the Flagyl does it's job well, the patient has to start replacing the good bateria that they've lost as soon as possible. I was fortunate enough to learn from someone else that their doctor ordered them to take a probiotic pill named Align along with the Flagyl. I immediately ordered it online, and my mother felt better within days of taking it. As my mother is 80, this truly was a life saver for her. Now she won't go a day without taking her Align.
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