Taking probiotics with antibiotics is one of the better-studied uses of probiotics. But the benefit belongs to specific strains, and timing matters. Here is what the evidence shows.
Written by Vita Globe Editorial Team | Reviewed against AGA 2020 guidelines, Cochrane reviews and NIH guidance
Should you take probiotics with antibiotics?
Evidence suggests certain probiotics can lower the risk of antibiotic-associated diarrhea. A JAMA meta-analysis of 63 trials found a 42% lower relative risk overall[1], and a Cochrane review in children found diarrhea in 8% of those given probiotics versus 19% of controls[2]. The NIH notes that starting L. rhamnosus GG or S. boulardii within two days of the first antibiotic dose helps[3].
Caveat: The benefit is tied to specific strains and doses. Most trials used lactobacilli or S. boulardii, and many did not document the exact strain.
Sources: Hempel et al., JAMA 2012 · Cochrane review (children), 2019 · NIH ODS · Verified 2026-09-27
IN THIS ARTICLE
Why do antibiotics cause diarrhea?
Antibiotics are designed to kill bacteria, and they do not always discriminate between the bacteria causing an infection and the many helpful ones living in your gut. That disruption is one reason antibiotic-associated diarrhea (AAD) is a common side effect. Probiotics have been tested for decades as a way to lower that risk.
If you are new to the topic, our overview Why Gut Health Matters explains what the gut microbiome does.
What does the evidence show?
This is one of the better-studied uses of probiotics:
| Review | Who | What it found |
|---|---|---|
| Hempel et al., JAMA 2012[1] | 63 trials, 11,811 participants | Relative risk of AAD 0.58 with probiotics (about 13 people treated to prevent 1 case) |
| Cochrane review, 2019[2] | 33 trials, 6,352 children | AAD in 8% with probiotics vs 19% of controls; at 5 billion CFU/day or more, 8% vs 23% (moderate certainty) |
Those are meaningful numbers. But look closer and the strain question appears. In the JAMA review, only 2 of 82 trials adequately documented the specific strains used, and most interventions were Lactobacillus-based[1]. The Cochrane authors concluded that Lactobacillus rhamnosus or Saccharomyces boulardii at 5 to 40 billion CFU per day looked most appropriate for children[2].
The AGA 2020 guidelines add a related, conditional recommendation: for adults and children taking antibiotics, they suggest specific strains or combinations, such as S. boulardii, over no probiotic to help prevent C. difficile infection. The evidence quality was rated low[4].
Does any probiotic work, or does the strain matter?
The strain matters. A systematic review of 228 trials found that probiotic efficacy is both strain- and disease-specific. For example, L. rhamnosus GG showed significant efficacy for preventing AAD in children but not in adults[5].
That is why we are careful here. Vita Globe Super Probiotic Gummies contain Bacillus coagulans and Bifidobacterium lactis, which are not the strains behind the strongest AAD evidence summarized above. We do not claim our gummies prevent antibiotic-associated diarrhea. If that is your goal, ask your clinician or pharmacist which specific strain and dose they recommend.
For a look at research on a high-dose probiotic in a different setting, see High-Dose Probiotic Helps Patients With Chronic Diarrhea.
When should you take probiotics during antibiotics?
- Start early. The NIH Office of Dietary Supplements notes that L. rhamnosus GG or S. boulardii started within two days of the first antibiotic dose helps reduce AAD risk[3].
- Space them from your antibiotic dose. A common practical approach is to take the probiotic a couple of hours before or after the antibiotic, rather than at the same moment. Guidelines do not set an exact interval, so follow your pharmacist's advice.
- Be consistent through the course. Take the probiotic daily as directed while you are on the antibiotic; follow-up in pediatric trials ranged from 5 days to 12 weeks[2].
- Never stop or change an antibiotic because you are taking a probiotic.
For general timing tips outside of antibiotics, see Best Time to Take Probiotics.
When should you call a doctor instead?
Mild, short-lived loose stools are common on antibiotics. Contact a clinician promptly if you have severe or watery diarrhea several times a day, blood in your stool, fever, significant abdominal pain, or signs of dehydration, especially during or soon after an antibiotic course. People who are seriously ill or immunocompromised should talk to their care team before taking any probiotic; see Probiotic Side Effects: What’s Normal.
The honest summary
- Probiotics reduced AAD risk in large meta-analyses[1][2].
- The evidence points to specific strains, mainly L. rhamnosus GG and S. boulardii[2][3].
- Start early in the antibiotic course and space doses apart as your pharmacist advises.
- A general "gut health" probiotic is not the same as the strains studied for AAD.
Our option
Vita Globe Super Probiotic Gummies – Pouch
Super Probiotic Gummies contain a live probiotic blend that includes Bacillus coagulans and Bifidobacterium lactis. The suggested use is 2 gummies once daily, and each resealable pouch holds 14 gummies. They are gluten-free, non-GMO and tested by an independent third-party lab. It is designed for everyday digestive support, not as a treatment or preventive for antibiotic-associated diarrhea.
Frequently asked questions
How many hours apart should I take probiotics and antibiotics?
A common practical suggestion is a couple of hours apart, but guidelines do not specify an exact interval. Ask your pharmacist, since it can depend on your antibiotic schedule.
Should I keep taking probiotics after my antibiotics are done?
Trials varied in how long they continued. There is no single rule. If you were using a specific strain for AAD, ask your clinician how long to continue.
Can probiotics make antibiotics less effective?
The usual concern runs the other way: an antibiotic can affect bacterial probiotics, which is one reason people space the doses. Never change or stop your antibiotic plan without talking to your prescriber.
Which probiotic is best for antibiotic-associated diarrhea?
The strongest evidence involves Lactobacillus rhamnosus GG and Saccharomyces boulardii[2][3]. Effects are strain-specific[5], so ask your clinician for a specific recommendation.
Sources
- Hempel S, Newberry SJ, Maher AR, Wang Z, Miles JNV, Shanman R, Johnsen B, Shekelle PG. Probiotics for the prevention and treatment of antibiotic-associated diarrhea: a systematic review and meta-analysis. JAMA. 2012;307(18):1959-1969. jamanetwork.com
- Guo Q, Goldenberg JZ, Humphrey C, El Dib R, Johnston BC. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev. 2019;4:CD004827. doi:10.1002/14651858.CD004827.pub5
- Office of Dietary Supplements, National Institutes of Health. Probiotics: Fact Sheet for Health Professionals. Updated March 25, 2025. ods.od.nih.gov
- Su GL, Ko CW, Bercik P, et al. AGA Clinical Practice Guidelines on the Role of Probiotics in the Management of Gastrointestinal Disorders. Gastroenterology. 2020;159:697-705. gastrojournal.org
- McFarland LV, Evans CT, Goldstein EJC. Strain-specificity and disease-specificity of probiotic efficacy: a systematic review and meta-analysis. Front Med (Lausanne). 2018;5:124. doi:10.3389/fmed.2018.00124
About the Vita Globe Editorial Team
The Vita Globe Editorial Team researches and writes our wellness content, working from peer-reviewed research, systematic reviews and guidance from bodies such as the NIH and the FDA. We cite our sources inline and update articles when the evidence changes.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This article is for informational purposes only and is not a substitute for medical advice. Talk to your healthcare provider before starting any new supplement, particularly if you are pregnant, nursing, taking medication, or caring for a child.
