As we head into cold and flu season, many of us will visit a doctor for treatment to deal with a nasty respiratory or chest infection.

While we don’t generally need medication to treat a viral infection, doctors will often prescribe a course of antibiotics to treat the nasty secondary bacterial infections that can develop while the body fights off the flu.

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Good and bad effects

These medicines are extremely effective at dealing with the infection as they kill the disease-causing bacteria and make it hard for these ‘bad’ organisms to grow and multiply.

While treating an infection with antibiotics can significantly reduce your recovery time, these powerful medicines may cause side effects such as:

  • Rashes
  • Diarrhoea
  • Nausea
  • Yeast infections

Another important consequence associated with antibiotic use is the impact these medicines have on the diverse microbiome in your gut – the complex ecosystem of beneficial bacteria that reside in your gut that aid digestion and play important roles in various important biological processes, including your immune response.

Probiotics support immunity by keeping in check the harmful bacteria we can ingest through the normal course of daily life.

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Broad impact

Unfortunately, antibiotics, particularly broad-spectrum antibiotics, are a blunt tool. When used to fight harmful bacteria, they cannot distinguish the ‘good’ bacteria from the ‘bad’.

While some options target specific species of bacteria, your doctor will ultimately determine which is best.

And in the absence of targeted testing and analysis, the default is usually the catch-all broad-spectrum option.

Consequently, a course or, worse, multiple consecutive courses, can wreak havoc on the healthy bacteria in your gut and may result in lasting changes to the balance and composition of the flora that live in your digestive system.

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Collateral damage

A study published in the journal Nature that looked at how 144 antibiotics commonly used in humans impact our gut health found that two classes of antibiotics – tetracyclines and macrolides – create “collateral damage” by killing off certain good bacteria in the gut and inhibiting the growth of other important strains.

A healthy intestine is home to trillions of beneficial bacteria – it is estimated that there are over 50 genera of bacteria that provide over 500 different species.

These changes in your gut flora can lead to antibiotic-associated diarrhoea, nausea, vomiting and other gastrointestinal side effects.

The resultant imbalance can also allow ‘bad’ bacteria to overpopulate your gut, which may hamper digestion and result in recurring infections and other ailments.

Worryingly, chronic or excessive antibiotic use may pose long-term risks. For example, a 2015 study published in the journal Nature Reviews Endocrinology found associations between excessive antibiotic use in early life and the risk of weight gain and obesity in later life.

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Probiotics to the rescue

For these reasons, doctors often prescribe probiotic supplements alongside antibiotics. These products may reduce the negative effects on your gut flora by repopulating the gut with a diverse range of beneficial bacteria to improve and restore the microbial balance in your intestines.

A systematic review published in BMJ Open that look at the use of probiotics to correct the imbalance of normal microbiota following a disruptive events like a course of antibiotics found that 83% of the probiotic products used by otherwise healthy individuals restored their gut microbiota.

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Incorporating probiotics

Doctors who prescribe probiotics typically recommend that people take these supplements a few hours after the antibiotic to stop the medicine from killing the probiotics.

Some doctors may suggest that patients wait a few days after they have completed their course of antibiotics before starting a regimen of probiotics.

In this regard, broad-spectrum probiotics help to repopulate the gut with a diverse range of beneficial bacteria and may help to avoid imbalances, including overpopulating the gut with a beneficial strain of bacteria, which can also cause gastrointestinal issues.

You can also support your gut before, during and after a course of antibiotics by loading up on foods that naturally contain healthy bacteria. These foodstuffs include fermented foods such as sauerkraut, yogurt, kimchi, and tempeh. And you can feed the bacteria in your gut by eating fibre-rich foods, such as nuts, seeds, beans, lentils, peas and berries.