Probiotic use is becoming increasingly popular
and can provide many benefits to patients,
especially those using antibiotics. Probiotics are
live, ‘good’ bacteria that colonize in the gut. The
use of antibiotics kills all bacteria including the
good bacteria. Probiotics help maintain digestive
health, which can be disrupted with prolonged
antibiotic use and can lead to antibiotic-associated
diarrhea or yeast infections. Probiotics can be
taken along with antibiotic treatment and for up
to a couple of weeks after finishing the antibiotic
course. Patients taking probiotics along with their
antibiotics should take them a couple of hours
apart.

Probiotics are also used to maintain digestive
health and is often recommended for acute
gastroenteritis or diarrhea. Taking a probiotic
supplement helps restore the normal flora in the
gut and can help reduce the duration of diarrhea
especially when used with rehydration therapy.

With the increasing popularity of probiotics also
comes the development and advertisement of
different probiotic products. When choosing a
probiotic supplement, patients should look at
some key items including strains, ‘strength,’
storage and expiration dates.

Strains
As previously mentioned, probiotics are live,
good bacteria and they come in many different
strains. Some of the most popular include:

• Lactobacillus acidophilus: supports a healthy
  immune system and is part of normal vaginal
  flora; is beneficial in reducing yeast infections
  in women
• Bifidobacterium lactis: helps breakdown body waste and aids in absorption of various vitamins and minerals
• Bifidocbacterium longum: helps to crowd out
  bad bacteria that cause discomfort and
  neutralizes everyday toxins in the gut; helps
  breakdown carbs without excess gas

Strength
Probiotics are measured in colony forming units
(CFUs) which measure the amount of bacteria in
each supplement. Supplements range in millions
to billions of units per serving size. An ideal
supplement contains billions of CFUs in order to
provide the most coverage and possibility of
recolonization with good bacteria.

Storage
Because probiotics are live bacteria, storage of
these supplements is very important to maintain
stability. Some probiotics are kept in the fridge
while others are guaranteed to maintain stability
at room temperature for a certain amount of time.

Expiration dates
Because of the importance of storage of probiotic
supplements, it is important to keep an eye on
expiration dates. Refrigerated supplements are
best kept at cooler temperatures but once left out
are good for about 4 weeks.

KEY POINTS

• You can take probiotics WITH antibiotics and for up to 2 weeks after
• Take antibiotics and probiotics at least 2 hours apart
• Keep an eye on expiration dates and storage
• Probiotics provide the most benefit in billions of CFUs
• Probiotics are also present in smaller quantities in foods
  such as yogurts

Ask the pharmacy staff for available probiotics
including refrigerated products!

Sandy Arjon
PharmD Candidate 2016
University of Kansas School of Pharmacy

References:
1. Floch MH, Walker WA. Recommendations for Probiotic Use—2015 Update: Proceedings and Consensus Opinion. J Clin Gastroenterol. 2015;49: S69,S73.
2. Lactobacillus. In: Micromedex 2.0. Truven Health Analytics, Inc. Greenwood Village, CO. Available at: https://www.micromedexsolutions.com. Accessed September 16, 2015.