The Symbiotic Duo

Disclaimer: In this article, some example pairings of antibiotics and probiotics are given. These can differ based on your conditions, medicinal history, and almost everything. This article is intended to give allopathic practitioners a glimpse into naturopathic medicine and see how the thought process of holistic medicine works for us. If you are willing to try combining probiotics with your antibiotics, please consult with your doctor first, and follow their advice.


Antibiotics can be highly effective in combating bacterial infections, but they often act like a double-edged sword, targeting both harmful and beneficial bacteria indiscriminately. This can disrupt the delicate balance of the gut microbiome, which is sometimes referred to as our second immune system. In fact, some research suggests that the gut microbiome may play an even more significant role in our overall health than our genetic makeup (Valdes, A. M., Walter, J., Segal, E., & Spector, T. D. (2018). Role of the gut microbiota in nutrition and health. BMJ, 361, k2179. doi:10.1136/bmj.k2179). As such, it is crucial to find ways to protect and restore the gut microbiome during and after antibiotic treatment, in order to maintain a healthy immune system and overall well-being.

That’s why I’d like to argue that doctors should always aim to prescribe probiotics alongside antibiotics to maximize patient health and minimize adverse effects.

Why Probiotics Are Good For You

Probiotics are beneficial bacteria that reside in our gut and contribute to our overall health. They play crucial roles in the digestive process, immune system function, and mental well-being. Here are some compelling reasons why probiotics are good for you:

  1. Improved gut health: Probiotics help maintain the balance of good and bad bacteria in the gastrointestinal tract. They aid in digestion, prevent inflammation, and combat harmful pathogens that can lead to gastrointestinal issues like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).
  2. Enhanced immune system: A healthy gut flora is essential for optimal immune system function. Probiotics have been shown to strengthen the immune system by stimulating the production of antibodies, increasing the activity of natural killer cells, and promoting a healthy inflammatory response.
  3. Mental health support: Research has revealed a strong connection between the gut and brain, known as the gut-brain axis. Probiotics have been linked to reduced symptoms of anxiety, depression, and stress, supporting the idea that a healthy gut contributes to a healthy mind.

The Case for Pairing Probiotics with Antibiotics

Antibiotics are essential for treating bacterial infections, but they can also have unintended consequences. By wiping out harmful bacteria, antibiotics can also disrupt the delicate balance of the gut flora, killing off beneficial bacteria in the process. This can lead to gastrointestinal problems like diarrhea, nausea, and abdominal pain. In some cases, it may even give rise to antibiotic-resistant infections.

Here’s why I believe that probiotics should be prescribed alongside antibiotics:

  1. Reduced gastrointestinal side effects: Taking probiotics in conjunction with antibiotics can help replenish the good bacteria lost during antibiotic treatment. This can minimize gastrointestinal side effects and promote a quicker return to normal gut function.
  2. Prevention of antibiotic-associated infections: In some cases, antibiotic use can lead to secondary infections like Clostridium difficile, which can cause severe diarrhea and life-threatening inflammation of the colon. Studies have shown that taking probiotics during antibiotic treatment can lower the risk of these infections.
  3. Improved antibiotic effectiveness: Some research suggests that probiotics may help enhance the effectiveness of antibiotics by promoting a healthy gut environment. This could potentially reduce the need for prolonged antibiotic use, lowering the risk of developing antibiotic resistance.

Pairing Examples

Antibiotic Probiotic Explanation of Symbiosis
Amoxicillin Lactobacillus acidophilus Can help replenish the gut flora disrupted by amoxicillin, reducing gastrointestinal side effects and preventing antibiotic-associated infections.
Cephalexin Bifidobacterium longum Supports the gut health by breaking down carbohydrates and can counterbalance the negative effects of cephalexin on gut flora.
Clarithromycin Saccharomyces boulardii A probiotic yeast that can help restore gut balance disrupted by clarithromycin, reducing the risk of antibiotic-associated diarrhea.
Metronidazole Lactobacillus rhamnosus Can help maintain gut flora balance during metronidazole treatment, reducing gastrointestinal side effects and supporting immune function.
Azithromycin Lactobacillus casei Helps maintain gut health and can alleviate gastrointestinal side effects caused by azithromycin, promoting a healthy gut environment.
Levofloxacin Bifidobacterium bifidum Can help restore the gut flora balance disrupted by levofloxacin, supporting immune function and reducing the risk of antibiotic-associated infections.
Penicillin Lactobacillus plantarum Can mitigate the negative effects of penicillin on gut flora, reducing gastrointestinal side effects and promoting a healthy gut environment.
Ciprofloxacin Bifidobacterium breve Helps maintain the balance of gut flora during ciprofloxacin treatment, reducing gastrointestinal side effects and supporting overall gut health.
Linezolid Lactobacillus reuteri Can help counteract the disruption of gut flora caused by linezolid, reducing gastrointestinal side effects and promoting a healthy gut environment.
Tetracycline Streptococcus thermophilus Supports the gut health by producing lactic acid and can help alleviate the negative effects of tetracycline on gut flora.


Many probiotics can be found naturally in a variety of fermented foods, making it easy and affordable to incorporate them into your diet.

  • Lactobacillus acidophilus can be found in yogurt, kefir, and some cheeses.
  • Bifidobacterium longum is present in certain types of yogurt and fermented milk products.
  • Saccharomyces boulardii can be found in kombucha, a fermented tea.
  • Lactobacillus rhamnosus, Lactobacillus casei, and Lactobacillus plantarum are commonly found in fermented vegetables like sauerkraut, kimchi, and pickles, as well as yogurt and other dairy products.
  • Bifidobacterium bifidum, Bifidobacterium breve, and Streptococcus thermophilus can be found in various types of yogurt and other cultured dairy products.
  • Lactobacillus reuteri is present in some sourdough breads and certain fermented dairy products.

By including these probiotic-rich foods in your diet, you can naturally support your gut health.


Probiotics are not only good for you, but they also play a crucial role in mitigating the adverse effects of antibiotics. As such, it’s essential for doctors to recognize the importance of prescribing probiotics alongside antibiotics to maximize patient health and minimize potential complications. By embracing this symbiotic duo, we can improve patient outcomes and support the fight against antibiotic resistance.