Probiotics With Antibiotics in Ireland: Can You Take Them Together?
Probiotics After Antibiotics (Ireland): Can You Take Them Together?
If you are taking antibiotics, the most common question is simple: should you take probiotics with antibiotics or wait until after the course. This Ireland-focused guide gives a clear answer, a practical timing rule, a duration rule, and key safety checks.
Evidence snapshot (links)
- General safety overview: NHS probiotics
- Systematic review evidence for AAD prevention: Cochrane Review CD006095
- Ireland-specific safety discussion: FSAI probiotics safety report (PDF)
- Ireland prescribing context: HSE antibiotic prescribing guidance
If you want official advice for your situation, your pharmacist or GP is the right source.
Quick answer...
- Yes. Many people take probiotics with antibiotics, but do not take them at the same time.
- Timing rule: separate the probiotic and antibiotic dose by around 2 hours.
- Duration rule: continue the probiotic for at least 7 days after finishing antibiotics. Many people use 7 to 14 days, then reassess.
- Safety rule: avoid self-starting probiotics without clinical guidance if you are severely immunocompromised, critically unwell, have a central line, or are giving them to a premature infant.
Seek medical advice urgently if you have severe diarrhoea, fever, blood in stool, dehydration, severe abdominal pain, or worsening symptoms.
Contents
- What antibiotics do to the gut
- How common is antibiotic-associated diarrhoea?
- Can you take probiotics with antibiotics?
- Timing: how far apart?
- Evidence: what systematic reviews report (plain English)
- Strains commonly discussed in AAD research
- How long after antibiotics?
- Safety: who should avoid probiotics?
- Ireland notes: regulation and label checks
- FAQs
- External references
1) What antibiotics do to the gut
Antibiotics treat bacterial infections. They can also affect non-target bacteria in the gut. Some people notice temporary digestive changes such as looser stools, bloating, or abdominal discomfort. In some cases, people develop antibiotic-associated diarrhoea (AAD).
Background reading: NHS overview of probiotics.
2) How common is antibiotic-associated diarrhoea?
AAD can occur during treatment or shortly after. Published clinical reviews commonly report AAD in the range of about 5% to 30%, depending on the antibiotic used, the person, and how AAD is defined.
Evidence background: Managing antibiotic-associated diarrhoea (PMC) and AAP Pediatrics paper noting incidence ranges.
3) Can you take probiotics with antibiotics?
Many people take probiotics during antibiotics and after antibiotics, often because they want to reduce the chance of diarrhoea or gut disruption. The key practical issue is timing. If you take a bacterial probiotic at the exact same time as an antibiotic dose, the antibiotic can reduce survival of that probiotic (depending on the antibiotic and the probiotic).
One important nuance
- Evidence is strain-specific. Results for one strain or product do not automatically apply to another.
- Outcomes differ. Some studies focus on AAD; others focus on microbiome recovery, which is not the same outcome.
- Evidence is mixed in some areas. Some research suggests certain probiotic strategies do not speed return to a person’s baseline microbiome after antibiotics in some settings.
Example of mixed findings on microbiome reconstitution: Suez et al. 2018 (PubMed).
If you want an Ireland-focused overview of probiotic labels and how products differ, see: Probiotics Ireland: Evidence-Based Guide for Irish Consumers.
4) Timing: how far apart should probiotics and antibiotics be?
A widely used practical approach in prescribing protocols is a 2-hour gap between the antibiotic dose and the probiotic dose. This is used to reduce the chance of the antibiotic inactivating the probiotic.
Timing examples you can copy
| Your antibiotic schedule | Simple rule | Example |
|---|---|---|
| Once daily | Probiotic 2 hours after (or 2 hours before) | Antibiotic 08:00 → Probiotic 10:00 |
| Twice daily | Keep a 2-hour gap from each dose | Antibiotic 08:00 & 20:00 → Probiotic 10:00 (or 18:00) |
| Three times daily | Choose a consistent window between doses | Antibiotic 07:00, 15:00, 23:00 → Probiotic 09:00 (or 17:00) |
If your antibiotic must be taken with food, follow that instruction. You can still keep the probiotic 2 hours away.
Protocol example stating “2 hours before or after antibiotics” and “continue for 7 days after the course”: Beds Formulary NHS Probiotic protocol (PDF).
Clinician reference noting a 2-hour gap may be prudent (and that yeast probiotics are unaffected by antibiotics): ISAPP clinician resource (PDF).
5) Evidence: what systematic reviews report (plain English)
Research on probiotics taken during or after antibiotics often focuses on whether probiotics reduce the risk of diarrhoea. Systematic reviews have reported that probiotics, as a group, can reduce antibiotic-associated diarrhoea risk in some populations, but results vary by strain, dose, and study design.
What this means in practice
- There is evidence of benefit for AAD in some settings, but it is not universal.
- Strain identity matters. “Probiotic” is not one single intervention.
- Safety screening matters. Higher-risk individuals should not self-start without clinical advice.
Evidence sources: Cochrane Review CD006095 and BMJ Open systematic review.
What strong guides add (and what you should watch for)
- Different antibiotics carry different diarrhoea risk, and studies use different definitions of AAD.
- Some articles overstate conclusions. Prefer reviews that clearly state limitations and heterogeneity.
6) Strains commonly discussed in AAD research
Probiotic evidence is usually discussed at the strain level. Two strains frequently discussed in the AAD literature are: Lactobacillus rhamnosus GG (LGG) and the yeast Saccharomyces boulardii. These are examples used in published research; they are not a guarantee of effect for every person.
Practical takeaways for consumers
- If a product label does not identify what is inside (strain details where available), it is harder to match it to research.
- Yeast probiotics are generally not inactivated by antibiotics, while many bacterial probiotics can be antibiotic-sensitive.
- Always follow label instructions and confirm suitability if you are on prescription medication or have a medical condition.
Clinician resource noting yeast probiotics unaffected by antibiotics: ISAPP clinician resource (PDF).
If you are comparing options, start with label clarity: strain disclosure, dose disclosure (CFU or mg), storage instructions, and expiry/batch details.
7) How long should you take probiotics after antibiotics?
There is no universal rule. Duration depends on the antibiotic, the length of the course, your symptoms, and your baseline health. A practical approach used in some prescribing protocols is to continue a probiotic for about 7 days after the antibiotic course ends. Many people use 7 to 14 days and then reassess.
Simple plan (easy to follow)
- During antibiotics: take your probiotic 2 hours away from each antibiotic dose.
- After antibiotics: continue for at least 7 days. Many people use 7 to 14 days, then reassess.
- If symptoms persist or worsen, speak to a healthcare professional.
Example protocol including “continued for 7 days after the course has finished”: Beds Formulary NHS Probiotic protocol (PDF).
When to seek medical advice
- Diarrhoea lasting more than 3 days
- Fever, severe abdominal pain, or significant weakness
- Blood or mucus in stool
- Signs of dehydration (dizziness, very dry mouth, low urine output)
In Ireland, your pharmacist is often the fastest first check. For urgent concerns, contact your GP or out-of-hours GP service.
8) Safety: who should avoid probiotics during antibiotics?
For most healthy adults, probiotics are generally well tolerated. The main caution is for higher-risk groups. Avoid self-starting probiotics without clinical guidance if any of the following apply:
- Severely immunocompromised (for example, active chemotherapy, transplant immunosuppression, advanced immunodeficiency)
- Central venous catheter in place
- Critically unwell or in ICU
- Premature infants (probiotics should only be used under neonatal guidance)
Common side effects (usually mild)
- Temporary bloating or gas
- Mild changes in bowel habit
Stop and seek advice if symptoms are severe, persistent, or you feel unwell.
Safety overview: NHS probiotics.
If you are pregnant, breastfeeding, taking medication, or under medical supervision, confirm suitability with a pharmacist or GP before using supplements.
9) Ireland notes: regulation and label checks
In Ireland, most probiotics sold in retail and online are regulated as food supplements rather than medicines. This affects what companies are allowed to claim on packaging and advertising.
- The FSAI publishes guidance on food supplements and discusses safety considerations for probiotics in supplements.
- The HSE is the safest place to read about antibiotic use and prescribing context.
- Food supplement claims must comply with EU rules on nutrition and health claims.
FSAI food supplement guidance: FSAI Food Supplements.
FSAI probiotics safety report (Ireland): Assessment of the safety of probiotics in food supplements (PDF).
Ireland antibiotic prescribing context: HSE Antibiotic Prescribing Guidance.
Optional: comparing probiotics in Ireland
If you are comparing products in Ireland, focus on label transparency rather than marketing language. Look for strain identification, clear dose information, storage instructions, and expiry/batch details.
If you want to compare available options, you can review our collection here: Probiotic supplements in Ireland.
CDS22-formula Probiotic is one multi-strain option available in Ireland. For antibiotic use, prioritise safe timing (2-hour gap), a sensible duration (at least 7 days after), and suitability for your health status.
Frequently Asked Questions
Can I take probiotics with antibiotics?
Yes, many people take probiotics during antibiotics. A practical approach is to separate doses by around 2 hours.
How far apart should I take probiotics and antibiotics?
A commonly used rule is a 2-hour gap (probiotic 2 hours before or 2 hours after the antibiotic dose).
How long should I take probiotics after antibiotics?
A common practical approach is to continue for at least 7 days after finishing antibiotics. Many people use 7 to 14 days, then reassess.
How common is antibiotic-associated diarrhoea?
Clinical reviews commonly report AAD in the range of about 5% to 30%, depending on antibiotic and individual factors.
Who should avoid probiotics during antibiotics?
Avoid self-starting probiotics without clinical guidance if you are severely immunocompromised, critically unwell, have a central line, or are giving them to a premature infant.
Are yeast probiotics affected by antibiotics?
Yeast probiotics such as Saccharomyces species are generally not inactivated by antibiotics, while many bacterial probiotics can be antibiotic-sensitive.
What side effects can probiotics cause?
Some people notice mild bloating or gas at the start. If symptoms are severe, persistent, or you feel unwell, stop and speak to a pharmacist or GP.
External references
- NHS overview of probiotics: NHS Probiotics
- AAD background and incidence ranges: Managing antibiotic-associated diarrhoea (PMC) and AAP Pediatrics (incidence ranges reference)
- Cochrane review (probiotics and AAD; CD006095): Cochrane Library
- BMJ Open systematic review (AAD): BMJ Open
- 2-hour separation protocol example (PDF): Beds Formulary NHS Probiotic protocol
- Clinician resource on probiotics alongside antibiotics (including spacing and yeast note) (PDF): ISAPP clinician resource
- Mixed findings on microbiome reconstitution after antibiotics: Suez et al. 2018 (PubMed)
- Ireland regulatory guidance on food supplements: FSAI Food Supplements
- Ireland probiotics safety report (PDF): FSAI probiotics safety report
- Ireland antibiotic prescribing guidance: HSE Antibiotic Prescribing Guidance