Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Probiotics are scientifically used to support or mitigate the side effects of antibiotics, particularly antibiotic-associated diarrhea (AAD) and disruption of normal gut flora. Multiple randomized controlled trials and meta-analyses have shown that certain probiotic strains—most notably Lactobacillus rhamnosus GG and Saccharomyces boulardii—can reduce the incidence and duration of AAD in both children and adults. A 2020 Cochrane review encompassing over 12,000 participants concluded that probiotics probably reduce the risk of AAD compared to placebo or no treatment, with a number needed to treat (NNT) of about 13. The proposed mechanism involves restoring gut microbiota balance disrupted by antibiotics, as well as enhancing mucosal barrier function and modulating local immune responses. While not all probiotic formulations or strains are equally effective, and some risk exists for immunocompromised patients, the overall evidence supports the adjunctive use of well-studied probiotics to prevent or lessen antibiotic side effects, especially diarrhea. Probiotics are not a replacement for antibiotics, nor do they prevent all antibiotic side effects, but their use for AAD is well-validated in the scientific literature.

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