Research-backed guide

Can I Take Probiotics with Antibiotics?

Yes, and the research suggests it's worth doing. Here's when, which strains, and for how long.

Antibiotics can't tell harmful bacteria from helpful ones, and diarrhea is one of their most common side effects. Several large meta-analyses have looked at whether probiotics help. Here's what they found.

  • By Vital Planet
  • 8 min read
  • 6 studies cited

What the meta-analyses found

  • 40%lower risk of antibiotic-associated diarrhea in adults, across 15 trials and 7,427 people1
  • 37%lower risk across 42 studies and 11,305 adults2
  • MultiMultistrain probiotics showed the strongest protection1

The short answer

Yes, for most people you can, and the evidence suggests you should. A 2025 meta-analysis of 15 trials in 7,427 adults found probiotics cut the risk of antibiotic-associated diarrhea by 40%, with multistrain products doing best.1 Start the probiotic early in the course,3 take it at a different time from your antibiotic, and keep going for a while after the course ends. If you're immunocompromised or seriously ill, ask your doctor first.

If you've ever been prescribed antibiotics, you've probably wondered whether taking a probiotic at the same time is safe, helpful, or even worth it. You may have heard conflicting advice from doctors, pharmacists and well-meaning friends.

Here's what current research shows: for most people, taking probiotics during an antibiotic course is safe, and several large reviews suggest it helps protect against one of antibiotics' most common side effects.

Why do antibiotics affect your gut?

Antibiotics are designed to kill bacteria. The problem is they can't tell harmful bacteria from the beneficial ones living in your gut, a bit like a weed treatment that also damages the grass.

The clearest picture of what that looks like comes from a 2018 study that gave 12 healthy men a 4-day course of three strong antibiotics and followed them for six months. Right away, Bifidobacterium species and butyrate producers dropped, and opportunistic bacteria such as Enterococcus faecalis bloomed. The gut community recovered to near its starting composition within about six weeks, but 9 species that everyone carried at the start were still undetectable in most of the men at six months.6

Helpful groups drop

Bifidobacterium and butyrate producers were among the first to decline.6

Opportunists bloom

Enterobacteria and other opportunistic bacteria expanded while the usual residents were down.6

Recovery takes weeks

Near-baseline in about six weeks, with a few species still missing at six months.6

Antibiotics are sometimes necessary and can be life-saving, so always finish the course your prescriber gave you. Understanding what they do to your gut simply helps you support it along the way.

What does the research say?

The evidence has grown substantially, and several meta-analyses, which pool data from many trials, point the same way.

Study Participants Key finding
2025 meta-analysis
15 trials		 7,427 adults Probiotics lowered antibiotic-associated diarrhea by 40% (RR 0.60). Multistrain products did best (RR 0.40, vs 0.6 for single strains and 0.9 for two-strain products).1
2021 meta-analysis (BMJ Open)
42 studies		 11,305 adults Probiotics lowered the risk by 37% (RR 0.63). A higher dose of the same probiotic did better than a lower dose.2
2021 meta-analysis
36 studies		 9,312 adults Probiotics lowered the risk by 38% (RR 0.62), with no increase in adverse events. The authors favored starting as early in the antibiotic course as possible.3

In the 2021 BMJ Open analysis, studies with a low baseline risk of diarrhea showed no difference; the benefit showed up where the risk was moderate or high.2

Which probiotic strains are best during antibiotic treatment?

Not all probiotics were equally effective in these trials, and only certain species, mainly Lactobacillus and Bifidobacterium, showed a benefit in the 2021 BMJ Open analysis.2 These are the best-studied options:

StrainWhat the research foundEvidence
Saccharomyces boulardii

A probiotic yeast, so antibacterial drugs don't target it. Across 21 trials and 4,780 people, it lowered antibiotic-associated diarrhea from 18.7% to 8.5% (about 53% lower), in both children and adults.4

Meta-analysis
L. rhamnosus GG

Across 12 trials, it lowered the risk from 22.4% to 12.3%. Split by age, the benefit was significant in children; in adults, only in people on H. pylori treatment.5

Meta-analysisStronger in children
Multistrain Lactobacillus + Bifidobacterium

Multistrain products showed the strongest protection in the 2025 meta-analysis,1 and Lactobacillus and Bifidobacterium were the groups that showed a benefit in the 2021 analysis.2 Bifidobacterium is also among the groups antibiotics knock down first.6

Meta-analyses

For more on why diversity comes up so often, see why strain diversity matters.

When and how should you take probiotics with antibiotics?

A simple routine covers the essentials. For the full picture on meals and timing, see when to take probiotics.

  1. 1

    Start early

    Begin your probiotic when you start the antibiotic. One meta-analysis favored starting as early in the course as possible.3

  2. 2

    Take it at a different time

    Many people take the probiotic a couple of hours away from the antibiotic dose. It's a common practical step; the trials themselves varied in how they timed doses. S. boulardii, as a yeast, isn't a target of antibacterial drugs.

  3. 3

    Take it with food

    Unless your probiotic is in a delayed-release or enteric capsule, taking it with a meal gives the cultures more protection from stomach acid.

  4. 4

    Keep going afterward

    Don't stop the day the antibiotic ends. In the recovery study above, the gut took about six weeks to get close to baseline,6 so continuing for a few weeks after the course is a reasonable plan.

Example schedule

If you take your antibiotic at 8 a.m. and 8 p.m., take your probiotic with lunch at noon. Consistency matters more than the exact time.

How long does gut recovery take after antibiotics?

Your gut microbiome doesn't bounce back overnight, and recovery varies with the antibiotic, the length of the course and your starting point. The best-documented timeline comes from the 2018 recovery study:6

  1. 0

    During the course

    Bifidobacterium and butyrate producers drop; opportunistic bacteria bloom.

  2. 6 wk

    About six weeks

    The gut community returns close to its starting composition.

  3. 6 mo

    Six months

    Most of the community has recovered, but 9 species that everyone had at the start were still undetectable in most of the men.

That study used a short course of three strong antibiotics in 12 healthy young men, so your own timeline may differ. Eating plenty of vegetables, fruits, whole grains and legumes gives recovering gut bacteria the fiber they ferment.

How to choose the right probiotic during antibiotic treatment

Feature Why it matters What to look for
Dose A higher dose of the same probiotic did better in the 2021 BMJ Open analysis2 A high-potency daily formula
Strain diversity Multistrain products showed the strongest protection1 Multiple Lactobacillus and Bifidobacterium strains
Delivery Cultures need to get past stomach acid Delayed-release or acid-resistant capsules
Quality You want what's on the label to be in the capsule Made in a cGMP-compliant facility, potency guaranteed through expiration

Support your gut during antibiotic treatment

60BVital Flora Ultra Daily Probiotic

Vital Flora probiotics

Developed by Brenda Watson, CNC. Our flagship Vital Flora Ultra Daily provides 60 billion cultures across 60 diverse Lactobacillus and Bifidobacterium strains, plus 7 organic prebiotics, in a delayed-release capsule designed to resist stomach acid.*

  • 60B cultures
  • 60 strains
  • Delayed-release
Explore our probiotics

Frequently asked questions

Many people take them a couple of hours apart as a practical step, and that's a sensible default. The more important thing, per one meta-analysis, is starting the probiotic early in the course.3 Saccharomyces boulardii is a yeast, so antibacterial drugs don't target it.

A few weeks is a reasonable plan. In one study that tracked recovery after a short antibiotic course, the gut microbiome took about six weeks to return close to baseline, and a few species were still missing at six months.6

Not in a way that cancels the benefit. The meta-analyses above tested probiotics taken alongside antibiotics and still found lower rates of antibiotic-associated diarrhea.1,2 Probiotic yeasts like S. boulardii aren't targeted by antibacterial drugs at all.

Broad-spectrum antibiotics, which act on a wide range of bacteria, tend to cause more digestive disruption. Clindamycin, amoxicillin-clavulanate, cephalosporins and fluoroquinolones are commonly associated with higher rates of diarrhea. Any antibiotic can affect your gut microbiome, though. Ask your prescriber what to expect from yours.

Most people can safely take probiotics with antibiotics, but check with your healthcare provider first if you're immunocompromised, critically ill, have a central venous catheter, or have severe acute pancreatitis. For more, see probiotic safety and side effects.

Eat a fiber-rich diet with plenty of vegetables, fruits, whole grains and legumes, since fiber feeds the bacteria that are recovering. Fermented foods like yogurt, kefir and sauerkraut can fit in too. Stay well hydrated, especially if you get diarrhea, and call your doctor if diarrhea is severe or bloody.

Research suggests higher doses help here: in the 2021 BMJ Open analysis, a higher dose of the same probiotic gave better protection than a lower one,2 and multistrain products did best in the 2025 meta-analysis.1 Antibiotics are the situation where the case for a high-potency, multistrain formula is strongest.* For more, see when 100 billion CFU makes sense.

Written by the Vital Planet team.

References

  1. Wanyama H, et al. Probiotic use reduces the incidence of antibiotic-associated diarrhea among adult patients: a meta-analysis. Prz Gastroenterol. 2025;20(1):5-16. PubMed
  2. Goodman C, et al. Probiotics for the prevention of antibiotic-associated diarrhoea: a systematic review and meta-analysis. BMJ Open. 2021;11(8):e043054. PubMed
  3. Liao W, et al. Probiotics for the Prevention of Antibiotic-associated Diarrhea in Adults: A Meta-Analysis of Randomized Placebo-Controlled Trials. J Clin Gastroenterol. 2021;55(6):469-480. PubMed
  4. Szajewska H, Kołodziej M. Systematic review with meta-analysis: Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2015;42(7):793-801. PubMed
  5. Szajewska H, Kołodziej M. Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Aliment Pharmacol Ther. 2015;42(10):1149-57. PubMed
  6. Palleja A, et al. Recovery of gut microbiota of healthy adults following antibiotic exposure. Nat Microbiol. 2018;3(11):1255-1265. PubMed
*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. This article is educational and not a substitute for medical advice. Always finish your antibiotic course as prescribed, and consult your healthcare provider before starting any supplement, especially if you have a health condition or take medications.
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