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What to Do If You Need to Take Antibiotics

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what to take with antibiotics
Taking antibiotics is never ideal, but sometimes it's necessary. iStock.com/amphotora

Note: The Prescript-Assist supplements discussed in this article are no longer available. Please click here to learn more about a substitute, the Daily Synbiotic from Seed.

I wrote this a while back when I had more time, thinking it might come in handy during the book tour. I was right!

A few years ago, I wrote an article about the often devastating effects that antibiotics can have on the gut flora. While it’s extremely important to avoid unnecessary antibiotic use, what about those who have carefully considered their options and decided that antibiotics are necessary in their situation? Is there no hope for recovering a healthy microbiome?

Need to take antibiotics? You need to read this article.

While having to take antibiotics is never ideal, there are many cases where it is absolutely necessary, and don’t worry – the situation is far from hopeless. It will take some time and effort, but there are many things you can do both during and after a course of antibiotics to minimize the damage and encourage regrowth and diversification of your gut flora.

Probiotics

To some, taking probiotics during a course of antibiotics might seem contraindicated. After all, won’t the antibiotics just kill all of the probiotics anyways? First, keep in mind that probiotics don’t need to actually colonize the gut to be beneficial; even transient strains can have powerful therapeutic effects.

There are quite a few randomized, placebo-controlled trials that have demonstrated the effectiveness of probiotic use during a course of antibiotics for reducing side effects and preventing gut infection. (1, 2, 3, 4, 5, 6, 7)

For example, a study on 135 hospital patients taking antibiotics found that only 12% of the probiotic-receiving group developed antibiotic-associated diarrhea, compared with 34% of the placebo group. (8) Additionally, while 17% of the placebo group developed diarrhea specifically from C. difficile, nobody in the probiotic group did.

One interesting study tracked changes in gut bacteria in three different groups of people receiving antibiotics, with one group receiving placebo, one group receiving probiotics beginning after the antibiotic treatment ended, and the third group receiving probiotics both during and after antibiotic use. (9) The group receiving placebo had significantly higher levels of facultative anaerobes (their chosen marker for gut dysbiosis) 20 days after finishing antibiotics compared with baseline, while the two groups receiving probiotics had no significant difference. But even though both of the probiotic groups ended up back at baseline levels, only the group taking probiotics during as well as after antibiotic treatment maintained stable levels of facultative anaerobes throughout the experiment. In the group receiving probiotics only after completion of antibiotic treatment, facultative anaerobes increased significantly during antibiotic treatment, and decreased only after beginning probiotic supplementation. This clearly demonstrates the importance of taking probiotics during antibiotic treatment, as well as after.

Most of these trials used different strains of Lactobacilli, Bifidobacteria, or Saccharomyces boulardii. Lactobacillus and Bifidobacterium are two of the most common genera used as probiotics, so these supplements are readily available in most health food stores or vitamin shops. S. boulardii is actually a beneficial yeast rather than a bacteria, so it’s particularly useful during antibiotic treatment because the antibiotics can’t kill it. S. boulardii is also preferable under these circumstances because there’s no risk of it harboring genes for antibiotic resistance and later transferring those genes to pathogenic bacteria. (10)

Another option for probiotics is a blend of soil-based organisms, such as Prescript Assist. I haven’t located any studies on their effectiveness in conjunction with antibiotics, but based on my clinical experience, I believe they’re a great choice.

As with anything else, the best probiotic to take will depend on a person’s particular circumstances (such as the antibiotic they’re on and the state of their digestive system), but the two supplements I recommend most often are S. boulardii and Prescript Assist. If you don’t do well on either of those supplements or just wish to add more variety, feel free to add in a supplement with strains of Lactobacillus and Bifidobacterium. Do your best to take any probiotic supplement as far away from your antibiotic dose as possible.

Prebiotics

As I’ve mentioned before, prebiotics are much more effective than probiotics at promoting the growth of beneficial bacteria in the gut. Thus, prebiotics are an incredibly important part of any regimen to protect or rebuild a healthy microbiome.

During and after antibiotic use, focus on getting plenty of soluble fiber, which feeds beneficial bacteria and is found in starchy tubers, squash, and peeled fruits. It might be best to avoid too much insoluble fiber while your gut is in a compromised state, since it can be irritating to the gut lining.

However, one type of insoluble fiber that can be extremely helpful for supporting healthy gut flora is resistant starch. (11) I’ve talked about resistant starch before here and here, and the easiest way to get a concentrated dose of RS is to use Bob’s Red Mill unmodified potato starch. As with any supplemental prebiotic, it’s a good idea to start with a small amount and work your way up. In this case, you could start with 1 teaspoon and work your way up to 2-4 tablespoons per day. If you find that RS doesn’t work well for you, you might consider trying an inulin-based prebiotic.

If possible, introduce any prebiotic supplements before beginning the course of antibiotics so your body can get used to them. That way, you won’t have to deal with possible side effects from introducing the prebiotic on top of possible side effects from the antibiotics.

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Supporting diversity

As I mentioned in my article about the impact antibiotics have on gut flora, the main difficulty after a course of antibiotics isn’t recovering the number of flora present; it’s recovering the diversity. As we’ve seen, probiotic supplements can be incredibly helpful for preventing antibiotic-associated diarrhea and lowering the risk of a gut infection, and I recommend continuing with probiotic supplementation for a period of time after finishing your treatment. However, you can’t expect manufactured probiotic and prebiotic supplements to achieve the diversity of an ancestral microbiome on their own.

One of the best ways to expose yourself to more diverse beneficial bacteria is by consuming fermented foods, so I highly encourage you to experiment with a variety of different ferments.

These can include kefir, beet kvass, sauerkraut, kombucha, kimchi, and other fermented vegetables or fruits. Keep in mind that foods like yogurt and kefir will probably only have a handful of bacterial strains if you buy them from the store, so homemade is best.

Another way to diversify the bacteria you’re exposed to is by gardening or otherwise getting your hands dirty, although I haven’t seen any research on whether that exposure translates to a more diverse set of gut bacteria.

As far as prebiotics go, just try to get as much variety in your plant foods as you can, in addition to supplementation with resistant starch or another prebiotic formula. Some of the best sources of soluble fiber include carrots, winter squash, summer squash (especially peeled), starchy tubers, turnips, rutabagas, parsnips, beets, plantains, taro, and yuca. Green bananas and unripe plantains (which you can dehydrate to make chips) are good whole-food sources of resistant starch.

Support for the Gut and the Liver

When antibiotics throw your gut flora into turmoil, the gut lining and digestive function as a whole take a hit too. To soothe your digestive system, it’s a good idea to ramp up your consumption of bone broth and other glycine-rich foods while you’re on antibiotics, and continue to consume these foods after the treatment is finished to promote healing.

If you experience nausea or other digestive upset from the antibiotics, ginger can be extremely helpful for reducing inflammation and calming the digestive system. (12, 13) It’s best to use fresh ginger, and you can easily make ginger tea by slicing it and simmering it in water until the tea reaches your desired strength.

Antibiotics can also take a toll on your liver, particularly if you’re on them for an extended period of time. Not only is the liver is responsible for processing and detoxifying medications, it also has to deal with extra circulating lipopolysaccharides from the increased bacterial death and intestinal permeability. Milk thistle is one of my favorite supplements for supporting liver health, and can be taken in a pill (like this one) or as a tea. (14, 15) Glycine is also important for liver detox, so be sure to drink that bone broth!

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303 Comments

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    • i used Aloe Muciliginous Polysaccharride capsules to address infections like ulcers and pouches in the colons.

      1 bottle cost $126. It has 270 capsules. I am going to experiment using 7 capsules per week (maybe 2 capsules every 2 days) to protect my colon from infections as a form of maintenance so should nip any infection in the bid. It should last nearly 9 months.

  1. I have a herniated disk and have never heard of anything like that. I would be very reluctant to follow this course. If you have sciatic symptoms I highly recommend Neurontin (Gabapentin)

    • Herniated discs and back problems can be cured with Hyaluronic Acid (at least 3 tablets) on empty stomach. You can take higher dose in first weeks because it accumulates in your body. Use the Biocell version because it absorbs well. It takes 6 weeks to cure it. You will likely notice if it is working within first two weeks or maybe even days.

      So throw the antibiotics and neurontin into the waste basket.
      No need for it.

        • So you actually gave the Biocell HA/Collagen. How many tablets and what brand did you use ? Did you take it on empty stomach. For how long ? Did you get any improvement ?

    • I know the post about the herniated disc is older but for anyone interested this method worked for me to treat my herniated disc. I followed this to a day every day and then went to a clinic to get the next set of “e-sizes” and after two months I was completely healed.

      http://www.amazon.com/Pain-Free-Revolutionary-Stopping-Chronic/dp/0553379887

      I have used this book for 15 years, the e-sizes always work for various injuries. I know follow the “final set” every day. I have no pain. Highly recommend.

  2. Hi, the following regime has been recommended for a longstanding back pain problem (modic changes in verbetral bones adjacent to a herniated disc).

    “….one tablet = 500 mg amoxicilin and 125 mg clavulan acid) in a dose of 2 tablets 3 times a day with an 8 hour sequence for 100 days…..”

    This is a massive dose of antibiotic – anyone else used this protocol and been ok on it? Interested in any views.

      • hi sarah, i just came off the exact same antibiotics for a nasty infection in a dental implant i have just had removed. i am taking glycine in the form of great lakes hydrolysed collagen (from iherb), and a probiotic called biokult (which is excellent clinical grade and stable through stomach acid). i have been eating traditionally fermented foods (veges, kombucha, home made yoghurt etc) for years now but make sure to have them several times a day at present. its 3 days since ceasing the metronidazole (which i suspect was causing the bowel inflammation and diahorrea) and i am back to normal today phew!

  3. I am taking Doxycycl HYC 100mg twice a day because of a tick bite. I was looking for probiotics from food to take with this antibiotic. Your article had good info.

    • Here is a collection of things different people are taking using long term antibiotics

      Saccharomyces
      Ultra flora IB
      Phobiotics
      Ther-Biotic Detoxification Support (Vegan)
      Dr. Ohirra’s “Professional Formula”
      Probiotic (lactobacilli and bifidobacteria)
      VSL#3
      Kefir
      Fermented foods such as pickles, sauerkraut, kimchee and miso
      refrigerated bottle of liquid ACIDOPHILUS PRIOBIOTICS 1tbls per day.

      Please be aware that what works for one person may not work for another. It is a trial and error and finding what works for you.

  4. My father is on co amoxiclav and moxifloxacin hcl for his foot wound. he is diabetic and thats why the healing of wound is taking so long, before this prescription he was taking clindamycin, all of these antibiotics are causing quite severe side effects diarrhea, fatique and weakness. what specifically should he use in his diet to improve his condition keeping in mind he is diabetic not allowed to eat lot of sugar
    thanks

    • Saccharomyces Boulardii can be used to treat the antibiotic caused diarrhea. Take in between meals.

  5. Dear Mr Chris,

    First of all, I would like to appreciate you and this website..which is more helpful for the peoples.who has lack of knowledge on pro-biotic and Pre-biotics.

    I am writing my story to seek you help, Hope you would also help me to overcome my life-threatening situation.

    I was having stomach ache for the past 8 months and before two months, One of gatstro-enterologist found H-Pylori infection during gastroscopy by doing Biopsy.

    Post to that the same Dr Prescribed the H-Pylori antibiotic Kit contains ( Amoxicillin Capsules 500 mg – Thrice a day
    Metronidazoles Tables 400 mg Thrice a day (14 tables), Omeprazole – Thrice a Day ) for 10 days. Which i have completed with horrible side effects, Like nausea, Drowsiness, Stomach pain, Chest Pain, High Wind, Neck and Sholder Pains and more.

    Post i have completed this medicines, I have faced lot of difficulties until now. Continuously being to ER at nearest hospital due to high-Fatigue ( Which i could not do anything and being on bed ) , Stomach pains, full muscle pains, body pains, Urinary Tract infections and Leg pains, Throat pains etc…

    overall my situations is being worst now, I could not able to do anything and could not able to sleep even.

    I recently came to know about this Pro & Pre-biotics and I bought VSL#3 capsules. But not sure whether it would work for me or not.

    Kindly help me and suggest, How to come out of this traggetic situation.

    Awaiting for your valuable reply to save my life.

    • I don’t think Chris will have the time to answer you.

      No doctor will be able to tell you if something will work. Health conditions can be complex especially gut issues. You can have preexisting issues and post issues. You will have to approach it from different angles.

      One angle is to use VLC#3 and see if that helps.

      Next angle is to treat potential infections like fungal.

      Next angle is to introduce fermented foods like kefir.

      Next angle is to research other supplements mentioned in comments and test them.

      It will be a trial and error approach for you like everyone else.

    • You really should get tested for Lyme disease if you have not done so.

      iGenex lab in California is best.

      My wife was undiagnosed Lyme for 8 years and had a myriad of symptoms that could not be explained by the experts. We are just beginning her lyme treatment now. Hoping to put this nightmare behind us.

    • Hi Krishnan, I read your post and I can shed some light on that especially as I am going through the same thing… Gut days biopsies due to antibiotics and amalgam fillings… Do you have any fillings ( which are actually 50% mercury) which are a contributing factor to dysbiosis. You must consider having these removed by a qualified mercury free dentist ! Let me know!!

  6. What a wonderful site, thank you.

    Last night I was prescribed the antobiotic clyndamycin for an infected tonsil, after the er doctor drained most of the pus.

    My question to you is what is the alternative to abtibiotics in this case?

  7. Thank you. I’m going to start her on it today. Also looking into ionic silver water. Wish there was more info available, but I’ve had decent luck with a couple of forums. Know if there is truth to harmful bacteria feeding off of sugar? Baby doesn’t eat much, but if she hasn’t eaten all day I try anything (to prevent nausea from meds) even if that means ice cream.

    • There is a brand of coloidal silver that has been tested and used by the US military. I tried it. It is very potent.

      “American Biotech Labs Silver Biotics 4 oz Scientifically Tested by US Military Hospital”

    • Here is another one to try. Lot of positive reviews on it.

      Lactobacillus Sporogenes (Bacillus Coagulans)

  8. I have a 16 month old who has had 3 kidney infections in the last 5 months. The first was Pseudomonas aeruginosa and was treated with Cipro. She has VUR, so was put on a daily antibiotic after the Cipro, that was Bactrim. She had 2 e. coli kidney infections while on the Bactrim and those were both treated with Cefdinir. We just found out she has a c. diff infection and was today prescribed with Flagyl. Earlier this week I told her urologist that I do not want to try a new daily preventative antibiotic they are recommending because I suspect that her first treatment of Cipro was what left her so vulnerable to additional infections and I wanted to give her little body a chance to get it’s defenses back up (this was before I found out she has c.diff infection). We took Culterelle during her first round of antibiotics, but I only recently became aware of what gut flora actually is. We just started her on an infant probiotic with 5 different strains, trying to give her sips of Kefir, Kombucha, etc. She hasn’t had an appetite since all of this started, so food is hard. She is pretty much exclusively breast fed at this point. I’m in tears over her being either with infections or on antibiotics. Any advice would help. Interested in s. boulardii perhaps to help treat the c. diff as well as any other ways to help get her gut in the right place. I’ve read mixed info on whether probiotics I ingest will transfer to her through my breast milk.

    • I would experiment with Saccharomyces Boulardii.
      It supposedly has been shown to normalize c diff and h pylori.
      The dosage has to be researched. Different research
      studies used different dosages. It also prevents antibiotic diarrhea. I’d consider taking this if taking antibiotics irregardless.

    • i just read recently that s. boulardii is one of the main bacteria in kombucha. can you dilute it and second ferment with raspberry or something to get her excited about it? my toddler LOVES kombucha.
      I really feel for you. Sally Fallon in recent years has produced a book called i think ‘nourishing traditions book of baby and childcare’ which is excellent. definitely take the fermented foods yourself to benefit her. Also consider high vitamin cod-liver oil and butter oil which contains high vit D for immunity this will be outlined in the book. best wishes from another breastfeeding mama x

      • Love you comment , Cowgirl! High vitamin Cod liver oil and bone broth definitely worth a shot! Also raw cows milk over pasteurized…if you are drinking. Best of luck to you and stay strong!
        Try to seek out a homeopath who can help you find the root cause of her illness.

  9. I am being treated with antibiotics for late stage Lyme Disease. I am taking both supplements that you mentioned in this article. My question is whether you have any advice as to WHEN I take the supplements in relation to the antibiotics. My LLMD advises taking probiotics 1 hour before the antibiotics (or 2 hours afterward). Have you come across anything in your research related to timing of probiotics during antibiotic treatment? Thank you!

  10. Hi there,

    I know probiotics should be taken 2-3hrs away from antibiotics, but what about other supplements like – milk thistle, Glutamine, fibre, etc.

    Thank you

  11. Chris, I hope you still reply to these posts. My 12 year old daughter is in the hospital trying to recover from terrible digestive issues. She is now on a feeding tube because she has become so malnourished.

    She had pneumonia in December 2013. She has scoliosis and we were worried she could not cough up the stuff in her lungs so we allowed the antibiotics. She was almost hosptialized then. She ended up on 2 antibiotics at the same time, Cefdinir and Azithromycin. They also gave her an inhaler, but we only used it 2 times.

    She has suffered from nausea ever since. We did give her high level probiotics afterward, but they had no affect. In March she started eating less because the nausea was getting worse, which in turn caused some constipation and gas which caused less eating. Then acid reflux started. She was put on nexium. Everything snowballed into some gastroparesis and her being in terrible pain. She can verp up undigested food eaten 6 hours earlier.

    We have been to numerous doctors and have had every test known to a GI specialist. They could only confirm that she was terribly constipated and has acid reflux, but her esophagus, stomach, and intestines are in great shape. She had mild resolving gastritis from the acid reflux. And her lg intestines were slightly dialated from the constipation.

    She has lost 17 pounds and refuses to eat much because of the pain. I know she needs the feeding tube now, and it will probably restart her stomach. And with eating, the pain may go away. But the nausea was there before any changes in eating or malnourishement, and I am worried it will remain.

    The doctors are worried it will or has turned into an eating disorder. She is not the type of child who has ever been worried about what others think, very confident and secure in who she is. But when something so primal as eating can make you feel like your guts are being cut out, I don’t know what that can do to your future thoughts of food and fear.

    I have even requested them to test her for Addisons. I have also talked them into doing an ultrasound of her abdomen to see if she could have gallstones. I would appreciate any suggestions. I have spent hundreds of hours doing research and haven’t found the answer yet.

    • Hi Laura,
      I am so sorry. I can imagine how terrifying that would be! I highly recommend you read the GAPS Diet book. I think it will give you some insight into digestion. It was written by a neurologist/nutritionist for her autistic son. It may seem unrelated to what you’re dealing with, but it provides a good template for repairing digestive isssues (which Dr Campbell McBride believes are at the root of autism). It did amazing things for my severely impaired digestion which sent me to the ER with dehydration when I became severely under weight, where I was provided no answers and all tests came back normal. I did my own research and found this diet. Good luck in your search for answers.

    • There seems to be a lot of chronic idiopathic (unknown) nausea out there that people have been carrying around for decades of their lives with no resolution even getting practically all known medical tests.

      Based on that, I would not go down the conventional medical route to resolve the chronic nausea when eating food. Like so many health conditions, it’s clear their not interested in solving it. Sometimes it can be caused by vestibular origin. You have to do your own research and experimentation. I would stay away from pharmaceutical medications.

      Given that the cause seems precipitated by antibiotics, I would suggest looking into introducing fermented products when she gets out of hospitable. First on list would be Kefir Milk. This can heal the digestive tract in many unknown ways.

      Buying commercial Kefir milk is not only expensive but devoid of benefits so you want to find starter kefir grains and do your own homemade version. Even commercial yogurt is devoid of benefits.

      You want to use raw milk. You can use pasteurized milk but they need to be transitioned. I found my kefir milk grains locally by going to a website localharvest.org and calling one of the farms close to me. There may be other sources close by. Finding them locally is better since they don’t get dehydrated during shipping so will be more healthy. I can get raw milk at farmers market on certain days. You need to search for that also.

    • Milk kefir is a great idea. I have grains I’d happily send you 2 day in the mail and then they don’t need to be dehydrated. Just email me your address at [email protected]

    • Scoliosis and constipation send up red flags for me to check her thyroid. My daughter has Hashimoto’s (autoimmune thyroiditis) and her main syptoms were both of those. Also, think about testing her for gluten intolerance and its cross reactors with Cyrex labs, maybe the nausea is is linked to food intolerances. Best wishes.

    • Hi Laura,
      Pls look into SIBO ( small intestine bacterial overgrowth).
      I had very similar story as you describe and it was from overuse of antibiotics.
      It is based on some more recent research so not all the docs may be aware of it yet, you just need to find the right one.
      Hope it helps, Petra

  12. Thanks for the info. I’m defrosting my beautiful bone broth right now. Had unexpected root canal and I’m on AMOX/K CLAV 875 mg twice a day for 12 days. I had no choice on as my infection was really bad. I’m drastically increasing my probiotic intake to several times a day, eating more of my homemade fermented foods and raw fermented dairy (yogurt, kefir, cheese, etc.). Dentist knew I was freaking out over taking antibiotics so she prescribed the most gentle (I’m trusting her on this one).

    • I have H pylori and I’ve tried to eradicate it with natural remedies however it has not worked. So I’m going to start taking antibiocs this Friday.

      I made my own bone broth, you mention taking probiotic and prebiotic. I have saccharomyces boulardi and it is ok to mix with the Ressistant Starch and when is it better to take it.

      This are the antibiotics i’m going to take
      Lansoprazole Capsules (Gastro-Resistant) 30 mg (28 Capsules)
      Amoxicillin Capsules 500 mg one to be taken three times a day (21 capsules)
      Metronidazoles Tables 400 mg one to be taken twice a day (14 tables)
      Thanks for your help

  13. Will this same help apply if you have to take a 6 day regiment of prednisone? Thank you.

  14. I am dealing with type one diabetes chronic fatigue Candida and unresolved thyroid issues, As well as digestive stuff.

    I told my doctor yesterday I was having pain near my left kidney(I thought it was just my adrenals screaming) She did a urine dip, Which came back with pus in my urine at an elevated level. She had them take a culture on it which will be available in three days. She also sent me for an ultrasound, I won’t see the doctor for another week but apparently I have a growth on my bladder.

    Before I left the office to get the ultrasound, She was very firm about me taking Cipro….. whatever that antibiotic is. I would rather wait until at least the culture comes back to see if I really really need it. I don’t feel any worse than I usually feel with all of my other ailments. The doctor was afraid that I would end up in the hospital on IV antibiotics.
    What do you think?? I’m part of the paleo code forum, but not sure how to access. The infection explains why I am so insulin resistant lately. Could the growth explain recent digestive issues? Is there something else I should take, like D-Mannose?
    Thanks
    Suzanne

    • DO NOT TAKE CIPRO unless you don’t care about getting ligament and tendon damage. Fluoroquinolones are known to cause this. There are numerous lawsuits, look it up. I’ve had persistent Achilles tendonitis for YEARS as well as shoulder impingement. Reviewing my records shows I was taking these drugs just prior to injury. I’ve gotten to the point that I list these drugs as allergens.

    • As far as kidney pain, it possibly could be kidney stones.

      There are a whole wide range natural remedies if that is the case. Some of those remedies were more complete and addressed infection. I used renavive for that reason. There are a broad spectrum of products and home remedies.

      You didn’t make clear what digestive issues you have.

  15. Great content on your site! I’m taking a long course of Rifaxamin for SIBO (which probably resulted either from a huge antibiotic and steroid hit I took last October for a bacterial infection that lead to epiglottitis + simultaneous strep; bears noting that I got GERD severely after infection and was told to take months of PPI); anyhow… I’m working with a new integrative doc who is more open to newer research; would love to know your recommendations for pre and pro biotics after the Rifaxamin course. Side note that I’ve also suffered from disequilibrium and nausea, body aches, and exhaustion – all of which receeding since rifax and elimination diet; CT Scan and MRI came back clean, but balance tests show loss on right side, which dovetails with my right ear and eye being sensitive to sound/light.

  16. my friend just sent me this article, and i’m so thankful. our family was in a terrible car accident about a month ago which resulted in my daughter having her spleen removed. this accident happened in panama, where we were on an 8 month sabbatical.
    the doctors there assured us that the other immune system organs (liver, bone marrow & lymph nodes) would take over the function of the spleen, and that our daughter would lead a normal healthy life.
    i was in contact with our kaiser pediatrician at that time, and she said the same thing, although she did emphasize the importance of keeping current on vaccines.
    when we got back last week, we were told to meet with an infectious disease doctor at kaiser, and she had a very different perspective. she said that my daughter is at extreme risk for bacterial infections and that she should be on low dose antibiotics (250mg penicillin 2x’s per day) for at least 2 years, and ideally 18 years. she also said that if she gets any fever at all, she should immediately take a dose of levofloxacin, and then go straight to the er for a blood culture. and she said these recommendations are based on research on patients with sickle cell, etc, not trauma induced spleenectomies.
    i feel extremely worried about putting my healthy child on antibiotics for an extended period of time. i’m worried that at the end of it, her immune system will be destroyed by the antibiotics, and that bacteria may develop a resistance.
    i’m researching using probiotics to support her immune system as long as she is on antibiotics. i’m also exploring alternatives to antibiotics. i’d love to hear your thoughts.

    • You should consider dropping your kaiser pediatrician or any physician who recommended vaccines. Vaccines will damage the immune system and set your daughter up for future chronic illness and cancer. It will make the current situation much worse. I hope you understand this. If you don’t, you better get off your ass and do the research on vaccines to inform yourself for your daughters sake.

      Look at the Amish. No vaccines and minimal processed foods = very healthy. Autism is very rare. chronic illness is virtually non existent. They even avoid GMO foods because they seen the devastating effects in their livestock. Removing fluoride from water will help too.

      Penicillin is a narrow spectrum antibiotic so don’t wipe out the gut flora. Narrow spectrum antibiotics are easier on body.

      The broad spectrum kind like levofloxacin are more devastating to gut flora. This increases the risk of fungal infections. doctors miss most fungal infections.

      I don’t want to say what you should do in regard to broad spectrum antibiotic but I think this is where you need to focus on. Removal of the spleen complicates things where you need more knowledgeable advice than me. If it is for a short term, it may be more acceptable.

      I am not against antibiotics but some can be very dangerous or bad effects on the body. You have to weigh the risk and rewards.

      I’d go along with low dose penicillin. People who have high risk of cellulitis infection have done well being on penicillin many years. Many years ago I took minocin for 3 years and had no negative effect on gut. I also experimented taking amoxicillin for 5 months. both are narrow spectrum antibiotics.

      There may be natural herbs in concentrated doses that can replace the antibiotics but that a murky area.

      I’d take any antibiotic with bromelain because it destroys the sheath that bacteria use to create bacteria resistance. Most people who developed antibiotic resistance resolved it with addition of bromelain.

      Being treated by conventional medicine increases the risk of more damage to your child so don’t follow their advice blindly or let them scare you. Find an alternative doctor that you can go to for advice if you can.

      Removal of an organ can end up forcing someone to be more dependent on conventional medicine also. It’s being caught between a big rock and the hard ground.

    • Prioris….so sorry about your daughter. I have been researching some possible natural anti microbial/biofilm disrupters to use on a regular basis that might interest you. These are what I have found:
      monolaurin or Laurcidin
      IP6
      NAC
      interfasePlus
      Grass fed colostrum with lactoferrin
      Thymus extract
      Beta glucan 1/3….I think there may be only one brand that works real well…my chinese medicine doctor carries it
      Prebiotic taken at same time as probiotic (RS taken with s. Boulardi, prescript assist, or other high quality probiotic)

      Hope this helps!

  17. Hi Dr. Kresser. Thank you for your article.

    I’ve had a bad cough for over a week that prevents me from sleeping, so right now I am taking prescription cough syrup and antibiotics (azithromycin).

    I am wondering: should I still take hydrochloric acid (HCL with pepsin) while I am taking this antibiotic? I am worried that the HCL will somehow make the antibiotic ineffective, or that I won’t be able to absorb as much vitamins/medicine if I don’t have enough stomach acid.

    Another, perhaps related issue: I’ve tried two different cough suppressants and they seem to have little or no effect on me. They don’t put me to sleep, and they only do a little bit to suppress any coughs.

  18. Hi Chris, thanks for all the great info. I am a huge fan of both your website and your book. My question involves the timing of the probiotic. I typically take prescript-assist with my meals; the antibiotic that I was prescribed should also be taken with a meal. Is this ok, or should I take the probiotic at a different time? Thanks in advance.

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<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/what-to-do-if-you-need-to-take-antibiotics/comment-page-3/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_1"><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_2"><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_4"><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='8218' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_5"><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Gut Health' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Gut+Health' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js_6" name="ak_js" value="66"/><script>document.getElementById( "ak_js_6" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
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<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/what-to-do-if-you-need-to-take-antibiotics/comment-page-3/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_1"><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_2"><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_4"><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='8218' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_5"><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Food Additives' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Food+Additives' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js_7" name="ak_js" value="134"/><script>document.getElementById( "ak_js_7" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
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<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/what-to-do-if-you-need-to-take-antibiotics/comment-page-3/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_1"><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_2"><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_4"><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='8218' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_5"><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='Diet-Heart Myth' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=Diet-Heart+Myth' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js_8" name="ak_js" value="2"/><script>document.getElementById( "ak_js_8" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>
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<div class='gf_browser_unknown gform_wrapper qc_box_container_wrapper gform_legacy_markup_wrapper' id='gform_wrapper_9' ><form method='post' enctype='multipart/form-data' id='gform_9' class='qc_box_container gform_legacy_markup' action='/what-to-do-if-you-need-to-take-antibiotics/comment-page-3/' novalidate> <div class='gform_body gform-body'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_below description_below'><li id="field_9_1" class="gfield field gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_1"><label class='gfield_label' for='input_9_1' >Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label><div class='ginput_container ginput_container_email'> <input name='input_1' id='input_9_1' type='email' value='' class='large' placeholder='Your Email' aria-required="true" aria-invalid="false" /> </div></li><li id="field_9_2" class="gfield health-concern field field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_2"><label class='gfield_label' for='input_9_2' >I want to improve my...</label><div class='ginput_container ginput_container_select'><select name='input_2' id='input_9_2' class='large gfield_select' aria-invalid="false" ><option value='' selected='selected' class='gf_placeholder'>I want to improve my...</option><option value='Weight' >Weight</option><option value='Energy' >Energy</option><option value='Digestion' >Digestion</option><option value='Brain' >Brain</option><option value='Overall Health' >Overall Health</option><option value='All of the Above' >All of the Above</option></select></div></li><li id="field_9_4" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_4"><div class='ginput_container ginput_container_text'><input name='input_4' id='input_9_4' type='hidden' class='gform_hidden' aria-invalid="false" value='8218' /></div></li><li id="field_9_5" class="gfield gform_hidden field_sublabel_below field_description_below gfield_visibility_visible" data-js-reload="field_9_5"><div class='ginput_container ginput_container_text'><input name='input_5' id='input_9_5' type='hidden' class='gform_hidden' aria-invalid="false" value='B12' /></div></li></ul></div> <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_9' class='gform_button button' value='Download eBook' onclick='if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_9"]){return false;} if( !jQuery("#gform_9")[0].checkValidity || jQuery("#gform_9")[0].checkValidity()){window["gf_submitting_9"]=true;} jQuery("#gform_9").trigger("submit",[true]); }' /> <input type='hidden' class='gform_hidden' name='is_submit_9' value='1' /> <input type='hidden' class='gform_hidden' name='gform_submit' value='9' /> <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' /> <input type='hidden' class='gform_hidden' name='state_9' value='WyJbXSIsIjVkYTAyNjYxOTg4ZDNhZGQwOTU0Yzc4NDcyNDk5YmM4Il0=' /> <input type='hidden' class='gform_hidden' name='gform_target_page_number_9' id='gform_target_page_number_9' value='0' /> <input type='hidden' class='gform_hidden' name='gform_source_page_number_9' id='gform_source_page_number_9' value='1' /> <input type='hidden' name='gform_field_values' value='popup_name=B12' /> </div> <p style="display: none !important;"><label>&#916;<textarea name="ak_hp_textarea" cols="45" rows="8" maxlength="100"></textarea></label><input type="hidden" id="ak_js_9" name="ak_js" value="235"/><script>document.getElementById( "ak_js_9" ).setAttribute( "value", ( new Date() ).getTime() );</script></p></form> </div>