The idea of "probiotics for therapeutic applications" first began in the early 1990s, when it was proposed by Nobel Prize winners Elie Metchnikof and Henry Tissie. After years of research and validation, its nutritional value and functionality have been widely recognized around the world, especially in the treatment of intestinal diseases, such as inflammatory bowel disease, irritable bowel syndrome and infectious diarrhea. In China's latest national essential drugs catalog, there are Bacillus subtilis, Bacillus subtilis diabolicus, Enterococcus diabolicus, Bifidobacterium bifidum diabolicus, Bifidobacterium bifidum triabolicus (including Lactobacillus bifidus triabolicus), and Bacillus licheniformis diabolicus.

Antibiotics refer to a class of substances produced by bacteria, fungi or other microorganisms in the course of their lives that have antipathogenic or other activities. Probiotics are live microorganisms and should be avoided in conjunction with antibiotics. In the treatment of some infectious gastrointestinal diseases, clinicians often prescribe antibiotics and probiotics and other related drugs. If antibiotics and probiotics need to be applied at the same time, the dose of probiotics should be increased or staggered, preferably at an interval of 2-3h or more. Saccharomyces boulardii, Clostridium casei and Bacillus preparations are not sensitive to antibiotics and can be used in conjunction with antibiotics.

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Chinese Preventive Medical Association Microecology Society Branch Pediatrics Group, Evidence-based guidelines for pediatric clinical application of probiotics[J]. Chinese Journal of Practical Pediatrics, 2017, 32(2):81-90.

SUN Wenjuan, ZHANG Bo. Development status and clinical application progress of probiotic preparations[J]. Chinese Journal of Hospital Pharmacy, 2015, 35(9):850-857.

Zhou J, Zhu J-P. Mechanism of action and application progress of probiotics on intestinal diseases[J]. Chinese Journal of New Drugs, 2015, 24(13):1484-1486.

The authoritative interpretation of Pharmaceutical Affairs, unauthorized reproduction, plagiarism will be punished.

It is best to keep them separate! Because taking them together reduces the function of probiotics.

At present, the common intestinal probiotics are Bacillus subtilis, Bifidobacterium bifidum, Bacillus licheniformis and so on. Its essence are bacteria, but these bacteria are not only not harmful to the human body, but beneficial, for regulating the gastrointestinal function is very good, especially for some patients with diarrhea.

Antibiotics kill bacteria. Of course, we hope that antibiotics would ideally kill only harmful, pathogenic bacteria. Unfortunately, though, antibiotics don't have eyes and can't kill only bad bacteria with the precision and accuracy of a missile. Even missiles often lead to accidental injuries. It's like the U.S. airstrikes in Syria, which are said to be against terrorists, but pretty much every time they kill and injure some civilians, including women and children. Thus, probiotics are similarly killed by antibiotics.

So it's best not to take probiotics and antibiotics together. If you do need to take them at the same time, it is best to space them out for a certain period of time. This can properly minimize the effect of antibiotics on probiotics.

In addition, when diarrhea, the doctor usually just give symptomatic, rehydration and other treatments, do not recommend antibiotics, is the same reason, because diarrhea exists in the bacterial imbalance, if you then take antibiotics will aggravate the bacterial imbalance, diarrhea will sometimes worsen. Of course, if there is clear evidence of bacterial infection, appropriate antibiotics are still needed.

Probiotics, are live microorganisms that are given in certain quantities and are capable of producing beneficial effects on human health. As medicines, probiotics are becoming more and more widely used in clinical applications.

Antibiotics have the effect of killing microorganisms, but clinicians often prescribe both types of drugs, so when these two types of drugs need to be used at the same time? What precautions should be taken when taking them?

I. Understanding Probiotics

There are more than 20 types of probiotics currently used in China, mainly Bifidobacterium, Lactobacillus, Clostridium casei, Saccharomyces boulardii, Enterococcus, Bacillus licheniformis and Bacillus cereus.

Some of the probiotic medications that we are familiar with are: Rejuveno, Pepcid, Jin Shuangyi, Serenocon, Mazengan, Mamma Mia, Liposomal, and EVERLIFE, among others.

II. Role of probiotics

Current research on the role of probiotics mainly focuses on the relationship between intestinal flora and the human body, because the human intestinal tract hosts a large number of 400 ~ 500 species of bacteria, known as "intestinal flora". Among them, there are both "friendly bacteria" and "harmful bacteria", which restrain each other and live in harmony, helping the human body to play important physiological functions, such as: defense against infections, participation in nutrient absorption and metabolism, and participation in the maturation of the immune system and play a normal immune-regulating role. They help the body perform important physiological functions such as defense against infection, participation in nutrient absorption and metabolism, maturation of the immune system and normal immune regulation. Once this amicable relationship is broken and "harmful bacteria" prevail, the flora will be out of balance, causing a series of diseases, and the use of antibiotics is one of the most important causes of "flora imbalance".

Probiotics vs. Antibiotics

Antibiotics are very commonly used drugs, its role is to kill or inhibit the invasion of bacteria and other pathogenic bacteria, the treatment of infectious diseases. However, antibiotics can not recognize "beneficial bacteria" and "harmful bacteria", especially cefoperazone, ceftriaxone, meropenem and other antibiotics with a wide range of antibacterial, strong antibiotic effect on probiotics kills a lot of bacteria, and often destroys the normal intestinal flora. So antibiotics are the "nemesis" of probiotics.

For the intestinal flora destroyed by antibiotics, we have to supplement probiotics in time and utilize probiotics to establish normal intestinal flora and reduce the side effects of antibiotics. For bacterial or fungal infectious enteritis, probiotic drugs should be used at the same time when antibacterial or antifungal drugs are used for treatment. So antibiotics and probiotics are a pair of "partners" again.

Fourth, can probiotics be used together with antibiotics?

As long as the relationship between probiotics and antibiotics as "nemesis" and "partner" is handled correctly, they can play a positive role for human health.

When probiotics and antibiotics are taken together, we need to be aware of the following:

1. Probiotics avoid being taken at the same time as antibiotics to avoid affecting the efficacy.If you need to take the same medicine, you should stagger the time of taking the medicine, preferably more than 2-3 hours apart.

2. Saccharomyces boulardii, Clostridium typhimurium and Bacillus are not sensitive to antibiotics and can be taken at the same time as antibiotics.However, S. boulardii is a fungus and should not be used in conjunction with antifungal medications, such as terbinafine tablets, miconazole capsules, and fluconazole tablets.

3. The use of antibiotics outside the gastrointestinal tract (intravenous drips) has less of an impact, and probiotics can usually be taken at the same time.However, when using antibiotics that are mainly excreted via the biliary tract, such as piperacillin, cefoperazone, ceftriaxone, and carbapenems that have a strong effect on the intestinal flora, the empirical administration of probiotics may be considered to prevent antibiotic-associated diarrhea when the course of medication is long.

4. If concomitant administration of preparations for the protection of the gastrointestinal mucosa is requiredWhen these medications are used, such as montelukast (Simethicone), bismuth, magnesium aluminum carbonate (Daxi), etc., these medications can adsorb live bacteria, and should not be taken at the same time as probiotic preparations, and should be spaced out for 1-2 hours.

Example: If you need to take cefaclor, probiotics and montelukast at the same time, you should take cefaclor orally on an empty stomach first and then montelukast after 1 hour, and then probiotics after 1 hour. Because Cefaclor is well absorbed on an empty stomach, most of it has been absorbed into the body or discharged from the intestines after 2 hours, so taking antibiotics after 2 hours will not affect the activity of probiotics.

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The original Yik Yak reminds you that when doctors prescribe antibiotic drugs for children, they sometimes add another probiotic preparation. This is because antibiotics don't discriminate between friend and foe; they kill pathogenic bacteria as well as probiotics. Therefore, when your child is taking antibiotics, he or she also needs to take probiotics to minimize the impact of antibiotics on the gut flora. And it should be noted that when your child is taking probiotic preparations and using antibiotic drugs, at least 2 hours apart, in order to minimize the impact of these drugs on the effect of probiotic preparations. Persistence to be effective, probiotics are not hormone drugs with the extension of the time of taking, the more obvious the effectiveness of probiotics. For example, for people with intestinal flora disorders, after taking probiotics for 1 week, they may feel an improvement; after taking them for 2 weeks, they will have an effect; after continuing to take them for 3 weeks, the effect will be obvious; therefore, if you want to continue to have an effect, you need to insist on taking probiotics. Supplement with probiotics to energize your health ......

Probiotics can not be used together with antibiotics, the role of antibiotics is to kill viruses and bacteria, but antibiotics will not accurately kill only viruses and bacteria, will also kill probiotics at the same time, which is the side effects of antibiotics, if used together with probiotics will offset some of the effects of each other, it is not recommended to be used at the same time, but after stopping antibiotics can be supplemented to make up for the antibiotic side effects.

Hello, this question has Dr. Chang to answer for you, click on the above attention, you can see more related questions Oh! ~

Antibiotics have the effect of killing bacteria, although probiotics belong to the beneficial bacteria, but in the eyes of antibiotics, probiotics are also bacteria, also to be eliminated, so in order to preserve the activity of probiotics, avoid taking with antibiotics. Of course, it's not that you can't supplement probiotics after taking antibiotics, you can take antibiotics first, and then take probiotics two hours later, which can ensure the survival rate of probiotics and achieve the best therapeutic effect.

I am Dr. Chang of Gut Microecology and Health.

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