Dr. Mary Galloway • Newberg, Oregon

The Antibiotic Apocalypse

  • Posted on Jun 13, 2017

In the June 12th edition of JAMA Internal Medicine, a broad study of patient records showed that antibiotic-induced adverse events were common in hospitalized patients.

Antibiotics work by killing harmful bacteria, starting in the GI tract. Because antibiotics are specific to the types of infections they control, your doctor will select a specific antibiotic to do the job. While this is critical for removing harmful bacteria, antibiotics also kill beneficial bacteria. This upsets the normal balance between beneficial and harmful bacteria, allowing the harmful bacteria to grow with little control from the beneficial bacteria. “Can’t I just eat yogurt or take a probiotic?” you say. Just like antibiotics, probiotics are specific to what they address. You need to select the right probiotic for your condition.

Probiotics are defined by the World Health Organization as “live microorganisms which when administered in adequate amounts confer a health benefit on the host”. The key to using probiotics successfully is using adequate amounts of the appropriate strains. The human body contains hundreds of strains of probiotic bacteria; science has identified only a small portion of the families and strains present. Two well-known probiotic families include Lactobacillus and Bifidobacterium. In these families, there are many strains, each with its own benefits. Families and strains can be likened to our own families. I may be in the same family as my sister, but she is good at math and I am good at chemistry. Even though we come from the same family, I would not send my sister to solve a chemistry problem.

Antibiotic use can result in diarrhea, constipation or yeast infections due to the loss of beneficial bacteria. If you select a probiotic that does not have adequate amounts of the particular strains needed, the results will be disappointing. Here is a basic list of conditions and the probiotics that are helpful:

1. Diarrhea due to antibiotics – Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum, Saccharomyces boulardii

2. Diarrhea due to C. difficile – Lactobacillus acidophilus, Lactobacillus casei

3.Diarrhea due to Rotavirus – Lactobacillus acidophilus, Lactobacillus rhamnosus.

When selecting a probiotic, be sure to purchase one that lists the desired probiotics at the top of the ingredient list. This helps ensure that the product contains enough of the probiotic to be effective. Consider using a dietary supplement that contains a combination of probiotic strains. Studies have shown that combination probiotic products offer greater benefits than single strain products. The additional strains assist the primary strains recolonize the colon and crowd out the harmful bacteria. Finally, select products that are free of gluten and do not contain FOS or inulin. These may stress the GI tract and slow the healing process.